{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T00:26:21Z","timestamp":1793406381290,"version":"4.5.0"},"reference-count":52,"publisher":"American Society for Microbiology","issue":"6","license":[{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/100019211","name":"AbbVie","doi-asserted-by":"publisher","award":["NA"],"award-info":[{"award-number":["NA"]}],"id":[{"id":"10.13039\/100019211","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2026,6,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Ceftazidime-avibactam (CAZ-AVI) is a crucial treatment for multidrug-resistant (MDR) gram-negative infections; however, the impact of treatment timing and outcomes in real-world practice remains unclear. This study evaluated CAZ-AVI use across diverse U.S. centers, with emphasis on early initiation. We conducted a retrospective cohort study at 22 U.S. medical centers (2019\u20132025), including adults with MDR gram-negative infections who received CAZ-AVI \u2265 72 h. The primary outcome was composite clinical success, defined as 30-day survival, absence of microbiological recurrence, and resolution of fever and\/or leukocytosis within 72 h of initiation. Early vs late initiation was assessed at 48 h. Classification and regression tree (CART) analysis was used to identify optimal thresholds. Among 613 patients (median age 60 years, 62.5% male, 57.1% admitted to the ICU within 24 h of index culture), the most common infection source was pneumonia (55.5%), and the most frequent pathogens were\n                      <jats:italic toggle=\"yes\">Pseudomonas aeruginosa<\/jats:italic>\n                      (36.1%) and carbapenem-resistant\n                      <jats:italic toggle=\"yes\">Enterobacterales<\/jats:italic>\n                      (34.7%). Composite clinical success occurred in 64.8%. CAZ-AVI initiation within 48 h was not significantly associated with improved outcomes (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.064). Among patients who did not receive prior active antimicrobial therapy (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 429), CART analysis identified a 42 h threshold. Initiation within 42 h was associated with higher clinical success (73.3% vs 63.4%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.046) and lower 30-day all-cause mortality (10.7% vs 19.1%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.030). In patients with pneumonia, the same threshold remained discriminatory, with improved clinical success and lower mortality. CAZ-AVI was effective for MDR gram-negative infections in real-world practice. Among patients without prior active therapy, initiation within 42 h was associated with improved outcomes, including in pneumonia.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/aac.00268-26","type":"journal-article","created":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T14:22:38Z","timestamp":1778854958000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":3,"title":["Ceftazidime-avibactam for multidrug-resistant gram-negative infections: outcomes and timing of initiation across 22 U.S. medical centers"],"prefix":"10.1128","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4891-8625","authenticated-orcid":true,"given":"Ashlan J.","family":"Kunz Coyne","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01070mq45","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Pharmacy Practice, Anti-Infective Research Laboratory, Eugene Applebaum 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