{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T19:21:26Z","timestamp":1790882486930,"version":"4.1.0"},"reference-count":73,"publisher":"American Society for Microbiology","issue":"11","license":[{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"name":"Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc."}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2025,11,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Ceftolozane\/tazobactam and polymyxin-based regimens are frequently used to treat pneumonia caused by multi-drug-resistant\n                      <jats:italic toggle=\"yes\">P. aeruginosa<\/jats:italic>\n                      (MDR-PSA). However, comparative data on global clinical outcomes between these therapies are limited. A multi-centered observational study was performed using the PINC AI\n                      <jats:sup>TM<\/jats:sup>\n                      Healthcare Database (2016\u20132022). The study population included hospitalized patients \u2265 18 years who were diagnosed with pneumonia and had MDR-PSA (defined as non-susceptible to \u22651 agent in \u22653 antimicrobial categories) on a respiratory or blood culture, receipt of ceftolozane\/tazobactam or a polymyxin-based regimen within 3 days of index MDR-PSA culture, receipt of \u22652 days of ceftolozane\/tazobactam or a polymyxin-based regimen, and without a COVID-19 diagnosis. A Desirability of Outcome Ranking (DOOR) analysis was performed. Components of the DOOR included in-hospital mortality, discharge destination (home vs other), recurrent MDR-PSA pneumonia, receipt of any renal replacement therapy (RRT) post-index culture in RRT-naive patients, and 30-day pneumonia-related readmissions. In total, 186 patients met the study criteria (104 ceftolozane\/tazobactam and 82 polymyxin). In the IPW-adjusted DOOR analysis, a ceftolozane\/tazobactam-treated patient had a higher probability of a more favorable outcome (DOOR probability: 61.3%; 95% CI: 56.8%, 65.7%). In the DOOR partial credit analyses, a ceftolozane\/tazobactam-treated patient had a higher probability of being discharged home alive with no undesirable outcomes than a polymyxin-treated patient (20.2% vs 9.8%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.04). This real-world evidence study of non-COVID-19 patients with MDR-PSA pneumonia suggests that patients treated with ceftolozane\/tazobactam have a higher probability of a more favorable outcome compared with patients treated with a polymyxin-based regimen. Further large-scale studies with detailed dosing are needed to validate the findings.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/aac.00569-25","type":"journal-article","created":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T14:55:39Z","timestamp":1758207339000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":7,"title":["Comparison of early treatment with ceftolozane\/tazobactam versus polymyxin-based therapy of pneumonia due to MDR\n                    <i>Pseudomonas<\/i>\n                    <i>aeruginosa<\/i>\n                    (PUMA)"],"prefix":"10.1128","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4730-0655","authenticated-orcid":true,"given":"Thomas P.","family":"Lodise","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/014hfaw95","id-type":"ROR","asserted-by":"publisher"}],"name":"Pharmacy Practice, Albany College of Pharmacy and Health Sciences","place":["Albany, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae","family":"Min","sequence":"additional","affiliation":[{"name":"Merck & Co., Inc.","place":["Rahway, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian H.","family":"Nathanson","sequence":"additional","affiliation":[{"name":"OptiStatim LLC","place":["Longmeadow, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emre","family":"Y\u00fccel","sequence":"additional","affiliation":[{"name":"Merck & Co., Inc.","place":["Rahway, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1306801"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000005298"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2016.174"},{"key":"e_1_3_4_5_2","unstructured":"Anonymous. Centers for Disease Control and Prevention (CDC). 2019. Antibiotic resistance threats in the United States. Atlanta GA: U.S. Department of Health and Human Services CDC. Available from: www.cdc.gov\/DrugResistance\/Biggest-Threats.html"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2011.03570.x"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dky279"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw353"},{"key":"e_1_3_4_9_2","first-page":"78","article-title":"Antibiotic selection in the treatment of acute invasive infections by Pseudomonas aeruginosa: guidelines by the spanish society of chemotherapy","volume":"31","author":"Mensa J","year":"2018","unstructured":"Mensa J, Barber\u00e1n J, Soriano A, Llinares P, Marco F, Cant\u00f3n R, Bou G, Gonz\u00e1lez Del Castillo J, Maseda E, Azanza JR, Pasquau J, Garc\u00eda-Vidal C, Reguera JM, Sousa D, G\u00f3mez J, Montejo M, Borges M, Torres A, Alvarez-Lerma F, Salavert M, Zaragoza R, Oliver A. 2018. Antibiotic selection in the treatment of acute invasive infections by Pseudomonas aeruginosa: guidelines by the spanish society of chemotherapy. Rev Esp Quimioter 31:78\u2013100.","journal-title":"Rev Esp Quimioter"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.7573\/dic.212527"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.48.12.4606-4610.2004"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2021.11.025"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciac268"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciz816"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.2147\/IDR.S350976"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa003"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13756-021-00933-8"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics11050626"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.37201\/req\/006.2021"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy766"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1080\/19466315.2016.1207561"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ495"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciac692"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofab466.1411"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(95)90733-5"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3181f208ac"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1128\/aac.00405-23"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.11.8711"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.4103\/idoj.IDOJ_130_20"},{"key":"e_1_3_4_30_2","unstructured":"European Medicines Agency. 2018. Guideline on the evaluation of medicinal products indicated for treatment of bacterial infections. European Medicines Agency. Available from: https:\/\/www.ema.europa.eu\/en\/documents\/scientific-guideline\/draft-guideline-evaluation-medicinal-products-indicated-treatment-bacterial-infections-revision-3_en.pdf. Retrieved 16 Jul 2018."},{"key":"e_1_3_4_31_2","unstructured":"United States Food and Drug Administration. 2010. Guidance for industry: antibacterial drug products: use of noninferiority trials to support approval. US Food and Drug Administration. Available from: https:\/\/www.fda.gov\/media\/71215\/download. Accessed16 Jul 2010."},{"key":"e_1_3_4_32_2","unstructured":"United States Food and Drug Administration. 2020. Guidance for industry: hospital-acquired bacterial pneumonia and ventilator-associated bacterial pneumonia: developing drugs for treatment. US Food and Drug Administration. Available from: https:\/\/www.fda.gov\/media\/79516\/download. 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