{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T00:43:25Z","timestamp":1788050605113,"version":"build-2784847793"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2024,12,17]],"date-time":"2024-12-17T00:00:00Z","timestamp":1734393600000},"content-version":"vor","delay-in-days":48,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,10,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Bloodstream infections (BSIs) caused by KPC-producing Klebsiella pneumoniae (KPC-Kp) are still associated with high mortality, and the game-changing drug ceftazidime\/avibactam has shown suboptimal pharmacokinetics in some clinical settings. Ceftazidime\/avibactam renal dose adjustment has recently been identified as an independent risk factor for mortality.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To investigate the effect of ceftazidime\/avibactam renal dose adjustment on mortality.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Patients with KPC-Kp BSI treated with a ceftazidime\/avibactam-based regimen were retrospectively collected and analysed. The primary outcome was mortality at 7, 14 and 30\u2005days after the start of definitive ceftazidime\/avibactam antibiotic therapy. Renal function was estimated using the CKD-EPI equation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>One hundred and ten patients with KPC-Kp BSI treated with a ceftazidime\/avibactam-based regimen were included. Full-dose ceftazidime\/avibactam (7.5\u2005g daily) was prescribed to 82 patients (74.5%), while 28 patients (25.5%) received a renal-adjusted dose (17 patients due to chronic renal disease or haemodialysis, 11 patients due to infection-related acute kidney injury), with a median of 1.9\u2005g daily. At multivariable analysis, receiving a reduced dose of ceftazidime\/avibactam was independently associated with mortality (HR 4.47, 95% CI 1.09\u201318.03, P\u200a=\u200a0.037), along with intra-abdominal or lower respiratory tract infections as source of BSI (HR 5.42, 95% CI 1.77\u201316.55, P\u200a=\u200a0.003), septic shock (HR 6.99, 95% CI 1.36\u201335.87, P\u200a=\u200a0.020) and SARS-CoV-2 coinfection (HR 10.23, 95% CI 2.69\u201338.85, P\u200a=\u200a0.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Dose reduction of ceftazidime\/avibactam according to renal function in patients with KPC-Kp BSI seems to be independently associated with higher mortality. This may be possibly due to inadequate exposure provided by the recommended doses for renal impairment.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jacamr\/dlae201","type":"journal-article","created":{"date-parts":[[2024,12,17]],"date-time":"2024-12-17T06:38:32Z","timestamp":1734417512000},"source":"Crossref","is-referenced-by-count":7,"title":["Impact of renal-adjusted ceftazidime\/avibactam in patients with KPC-producing <i>Klebsiella pneumoniae<\/i> bloodstream infection: a retrospective cohort study"],"prefix":"10.1093","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0832-7975","authenticated-orcid":false,"given":"A","family":"Oliva","sequence":"first","affiliation":[{"name":"Department of Public Health and Infectious Diseases, Sapienza University of Rome , Piazzale Aldo Moro 5, Rome 00185 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