4971 patients1–44
CRE
Pseudomonas
ESBL
Limited treatment options
Bacteraemia
Treatment with ZAVICEFTA suggested a trend towards lower all-cause 30-day mortality compared with colistin36*
- ZAVICEFTA was associated with a trend of improved clinical outcomes, decreased all-cause hospital mortality and improved benefit–risk outcomes, compared with colistin for the treatment of CRE infections36‡
ZAVICEFTA demonstrated promising clinical results for severe infections caused by OXA-48-producing Enterobacterales for which treatment options are limited38*
- The majority of patients (81%) received ZAVICEFTA as monotherapy38
- All-cause mortality was 14% at 14 days and 22% at 30 days38§
Consultant Microbiologist from Guy’s and St. Thomas’ NHS Trust talks about the benefit of new antibiotics to treat CRE. He also presents his experience using ZAVICEFTA in a patient in intensive care with MDR Klebsiella.
In the largest real-world study¶ with specific data on patients treated with ZAVICEFTA for P. aeruginosa infections, the composite clinical failure** and development of resistance was similar between the CRE and P. aeruginosa cohorts:4,49*
- Development of resistance to ZAVICEFTA was not detected in the patients evaluated with follow-up cultures4
- 8.4% of patients experienced a potential drug-related AE4
In a real-world retrospective multicentre study†† of patients who received ≥72 h of ZAVICEFTA for Gram-negative bacteria other than CRE, the clinical cure‡‡ rate was high across different causative agents:6*
- The only factor related to clinical failure was receipt of continuous renal replacement therapy at infection onset6
- Development of resistance to ZAVICEFTA was not detected in the patients evaluated with follow-up cultures6
- No treatment-related AEs were observed6
Treatment with ZAVICEFTA suggested a trend towards lower 30-day mortality compared with other treatment41*
- The overall 30-day mortality rate was 34.1%41
- The highest rate (36.5%) was among patients with bacteraemic KPC-Kp infections; the lowest (16.7%) was observed in those with urinary tract infections41¶¶
Treatment with ZAVICEFTA suggested a trend towards lower all-cause 30-day mortality compared with colistin36*
Treatment with ZAVICEFTA suggested a trend towards lower all-cause 30-day mortality compared with colistin36*
- ZAVICEFTA was associated with a trend of improved clinical outcomes, decreased all-cause hospital mortality and improved benefit–risk outcomes, compared with colistin for the treatment of CRE infections36‡
Treatment with ZAVICEFTA suggested a trend towards lower all-cause 30-day mortality compared with colistin36*
- The majority of patients (81%) received ZAVICEFTA as monotherapy38
- All-cause mortality was 14% at 14 days and 22% at 30 days38§
Treatment with ZAVICEFTA suggested a trend towards lower all-cause 30-day mortality compared with colistin36*
- In this real-world retrospective case series, where the majority of patients (n=23) had life-threatening infections, 73.7% of patients experienced a trend towards clinical and/or microbiological cure at the end of treatment39***
†IPTW-adjusted estimates; adjustment for confounding by indication was performed using IPTW.36
‡In a real-world, prospective, observational study in 18 US hospitals from 2011 to 2016 in 137 patients with documented CRE infections (bloodstream [46%], respiratory tract [22%] and urinary tract [14%] infections).36
§In a single-centre study in a Spanish hospital of a large cohort of patients with carbapenem-resistant infections caused by OXA-48-producing Enterobacterales who were treated with ZAVICEFTA as salvage therapy (N=57). Patients treated with ZAVICEFTA (for ≥48 hours) for any OXA-48-producing carbapenem-resistant Enterobacterales infection between 1 April 2016 and 31 December 2017. The most frequent source of infection was intraabdominal (28%), followed by HAP/VAP (26%) and urinary source (25%); bacteraemia was confirmed in 46% of patients.38
¶A multicentre, retrospective, observational cohort study conducted at six geographically diverse academic medical centres in the United States between 2015 and 2019. Inclusion criteria were as follows: (1) age ≥18 years and (2) receipt of ≥72 hours of ZAVICEFTA. For each patient, only the initial ZAVICEFTA treatment course during the study period was included.4
**The primary outcome was clinical failure defined as a composite of 30-day all-cause mortality, 30-day microbiological failure, and/or failure to resolve or improve signs or symptoms of infection on ZAVICEFTA.4
††This is a multicentre, retrospective case series of adult patients who received ZAVICEFTA for ≥72 h for documented infections caused by MDR Gram-negative bacteria other than CRE in 13 hospitals located in 9 Italian regions. The study was conducted from 1 July 2017 to 31 July 2019.6
‡‡Clinical cure was characterised as patients having complete resolution of clinical signs and symptoms related to the infection and/or infection cleared with no positive cultures reported at the end of ZAVICEFTA therapy.6
§§A matched cohort of patients whose bactaeremic KPC-Kp infections had been managed in the participating centres receiving ≥72 hours of salvage therapy regimens that did not include ZAVICEFTA. Cohorts were matched for days before salvage therapy (± 1 day) and Pitt bacteraemia scores (± 1 point) at the start of salvage therapy.41
¶¶In a retrospective, multicentre study in 17 Italian hospitals in patients with documented KPC-Kp infections (N=138). Patients treated for KPC-Kp infections between 1 April 2016 and 31 December 2017; 75% were bacteraemic and 25% were non-bacteraemic infections involving (in order of decreasing frequency) the lower respiratory tract, intra-abdominal structures, the urinary tract or other sites.41
***In a case series of 38 patients with infections caused by carbapenem-resistant Enterobacterales or P. aeruginosa who were treated with ZAVICEFTA as salvage therapy. Patients were treated in Europe and Australia between 2013 and 2016; 36 were infected with carbapenem-resistant Enterobacterales and two with carbapenem-resistant P. aeruginosa. The most common infections were intra-abdominal (n=15) and HAP/VAP (n=7), and 26 patients had bacteraemia.39
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