Ceftazidime-avibactam for multidrug-resistant gram-negative infections: outcomes and timing of initiation across 22 U.S. medical centers.
Document Type
Article
Publication Date
5-15-2026
Publication Title
Antimicrobial agents and chemotherapy
Abstract
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 (2019-2025), including adults with MDR gram-negative infections who received CAZ-AVI ≥ 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
First Page
e0026826
Recommended Citation
Kunz Coyne AJ, Judd C, Lucas K, Al Musawa M, Van Helden S, Holger D, et al [Yost C, VanDorf S] Ceftazidime-avibactam for multidrug-resistant gram-negative infections: outcomes and timing of initiation across 22 U.S. medical centers. Antimicrob Agents Chemother. 2026 May 15:e0026826. doi: 10.1128/aac.00268-26. Epub ahead of print. PMID: 42138697.
DOI
10.1128/aac.00268-26
ISSN
1098-6596
PubMed ID
42138697