Retrospective Evaluation of the Use of Ceftolozane/Tazobactam at a Large Academic Medical Center

Abstract

Background Ceftolozane/tazobactam is currently Food and Drug Administration–approved for the treatment of complicated intra-abdominal and urinary tract infections; however, it is often used in clinical practice for nosocomial pneumonia, particularly due to Pseudomonas aeruginosa. Previous data in this area are limited to small case studies. Methods This was a retrospective case series of all patients receiving ceftolozane/tazobactam for a variety of infectious indications at a large academic medical center. Results There were 60 cases included in this evaluation. Most patients were treated for pneumonia (34 [56.7%]), followed by intra-abdominal infection (11 [18.3%]), skin and soft tissue infection (3 [5%]), primary bacteremia (4 [6.7%]), bone and joint infection (2 [3.3%]), and pleural space infection (2 [3.3%]); 12 patient encounters (20%) had a concomitant bacteremia. Most patients had P. aeruginosa isolated (86.7%): 18 (34.6%) of these were non–multidrug resistant (MDR), 21 MDR (40.4%), and 13 extensively drug resistant (25%). The overall ceftolozane/tazobactam susceptibility rate was 83% with rates of 94.1%, 94.7%, and 45.5%, respectively, for non-MDR, MDR, and extensively drug-resistant isolates. Clinical cure was achieved in 25 (64.1%), clinical failure occurred in 10 (25.6%), and clinical status was unable to be determined in 4 cases (10.3%). Ten patients died in the hospital while on ceftolozane/tazobactam. Conclusions It seems that ceftolozane/tazobactam is a reasonable option for P. aeruginosa infections, yet prospective analyses are needed to further guide dosing recommendations and provide additional insight into patient outcomes associated with the use of this agent.