Ceftolozane/Tazobactam for the Treatment of Adults With Cystic Fibrosis: Results From a French Prospective Cohort Study.

IF 3.8 4区 医学 Q2 IMMUNOLOGY Open Forum Infectious Diseases Pub Date : 2024-08-06 eCollection Date: 2024-08-01 DOI:10.1093/ofid/ofae391
Pierre-Régis Burgel, Xavier Bourge, Carole Mackosso, Francois Parquin
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Abstract

Background: People with cystic fibrosis (pwCF) are particularly susceptible to respiratory infections, including those caused by multidrug-resistant (MDR) pathogens. Ceftolozane/tazobactam (C/T) is an antibacterial agent combination active against MDR gram-negative bacteria that has shown promising results in isolates from pwCF. This subanalysis is the first extensive observation of real-world C/T use in pwCF.

Methods: The multicenter observational CONDUCT study included consecutive patients, some with cystic fibrosis, who received ≥1 dose of C/T at 28 centers throughout France. Patients were treated according to hospital standards and followed up until the end of C/T treatment (EOT).

Results: Among 260 patients who had received ≥1 dose of C/T, 63 were pwCF, including 12 with previous lung transplant. The median age was 34 years and 55.6% of patients were female. Pseudomonas aeruginosa was the most frequently isolated pathogen (n = 40/41 [97.6%]). Most tested P aeruginosa strains (n = 65/73 [91.5%]) and all other isolated strains (Escherichia coli, Citrobacter koseri, Proteus mirabilis, and Serratia marcescens) were susceptible to C/T. Most patients completed the treatment duration, including those with historical β-lactam hypersensitivity. Reasons for stopping treatment were planned EOT and improvement in condition; overall, 88.9% of patients (n = 56/63) experienced improvement in condition. No new safety signals were identified. Mean forced expiratory volume in 1 second improved from 1.33 L to 1.47 L before and after C/T treatment, respectively (n = 52; P = .057).

Conclusions: C/T treatment was well tolerated and effective in pwCF, including those with previous β-lactam hypersensitivity.

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治疗成人囊性纤维化患者的头孢妥赞/他唑巴坦:法国前瞻性队列研究的结果。
背景:囊性纤维化患者(pwCF)特别容易受到呼吸道感染,包括由耐多药(MDR)病原体引起的感染。头孢唑烷/他唑巴坦(C/T)是一种对 MDR 革兰氏阴性菌有活性的抗菌药组合,在囊性纤维化患者的分离物中显示出良好的效果。本子分析是首次对 C/T 在 pwCF 中的实际使用情况进行的广泛观察:多中心观察性 CONDUCT 研究纳入了连续的患者,其中一些患者患有囊性纤维化,他们在法国各地的 28 个中心接受了≥1 次 C/T 剂量的治疗。患者按照医院标准接受治疗,并随访至C/T治疗结束(EOT):在接受≥1剂量C/T治疗的260名患者中,有63名是肺癌患者,其中包括12名曾接受过肺移植的患者。中位年龄为 34 岁,55.6% 的患者为女性。铜绿假单胞菌是最常分离到的病原体(n = 40/41 [97.6%])。大多数经检测的铜绿假单胞菌菌株(n = 65/73 [91.5%])和所有其他分离菌株(大肠埃希菌、柯氏柠檬杆菌、奇异变形杆菌和侯氏沙雷氏菌)对 C/T 易感。大多数患者都完成了疗程,包括曾对β-内酰胺类药物过敏的患者。停止治疗的原因是计划的EOT和病情改善;总体而言,88.9%的患者(n = 56/63)病情有所改善。未发现新的安全信号。C/T治疗前后,1秒内平均用力呼气量分别从1.33升提高到1.47升(n = 52;P = .057):结论:C/T治疗对pwCF(包括既往对β-内酰胺类药物过敏的患者)具有良好的耐受性和有效性。
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来源期刊
Open Forum Infectious Diseases
Open Forum Infectious Diseases Medicine-Neurology (clinical)
CiteScore
6.70
自引率
4.80%
发文量
630
审稿时长
9 weeks
期刊介绍: Open Forum Infectious Diseases provides a global forum for the publication of clinical, translational, and basic research findings in a fully open access, online journal environment. The journal reflects the broad diversity of the field of infectious diseases, and focuses on the intersection of biomedical science and clinical practice, with a particular emphasis on knowledge that holds the potential to improve patient care in populations around the world. Fully peer-reviewed, OFID supports the international community of infectious diseases experts by providing a venue for articles that further the understanding of all aspects of infectious diseases.
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