669. Real World Use of Ceftazidime/Avibactam for the Treatment of Multidrug Resistant Gram Negative Bacilli Infections: A Real World Experience from Two Centers in Mexico

Abstract

Abstract Background Ceftazidime-avibactam (C-A) is effective against many carbapenem resistant Enterobacteriaceae (CRE) and some carbapenem resistant Pseudomonas aeruginosa (CRPsa), indicated in complicated urinary tract infections (cUTI), complicated intra-abdominal infections (cIAI), and hospital-acquired pneumonia. To our knowledge, in Mexico, there is no data regarding the clinical efficacy (clinical cure) of its use in the treatment of cIAI, cUTI, hospital-acquired pneumonia, and the treatment of CRE and CRPsa. Methods this is a descriptive, observational, retrospective study, including infections in which ceftazidime avibactam was the definitive therapy for CRE and CRPsa, and empiric treatment of cUTI, cIAI, Hospital-acquired pneumonia. The study includes patients from 2 centers, between April 2019 and february 2020. Demographic, clinical and microbiological data were obtained. Clinical cure was defined as the absence of fever, leukocytosis, tachycardia, systolic pressure < 90mmHg or use of vasopressors, and lowering of C-reactive protein by at least 60% after 5 days of treatment. Results Seventy patients in which C-A was the definitive antimicrobial treatment were evaluated. UTI accounts for 24 cases (34.2%), followed by primary and secondary peritonitis (28.5%), soft tissue infection (12.8%), bacteremia (12.8%) and hospital-acquired pneumonia (11.4%). Of all infections 39.9% were secondary to CRPsa, and 60.1% were due to CRE (30.3% Klebsiella pneumoniae, 21.2% Escherichia coli and 6% for Klebsiella oxytoca, Enterobacter cloacae and Proteus mirabilis). Clinical cure was achieved in 64 patients (91.4%). Six patients died, but only one was associated to CRPsa infection. Conclusion To the best of our knowledge, this is the first study of Mexican experience with C-A. Our study brings relevant information on the treatment of carbapenem resistant GNB infections with C-A in our population. More studies, specifically RCTs are needed to prove the antibiotic efficacy in our media. Disclosures All Authors: No reported disclosures.