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Table 3 Clinical cure or success in mixed/unspecified bacteremia patients receiving C/T

From: Ceftolozane/tazobactam for the treatment of bacteremia: a systematic literature review (SLR)

Author, year

Study design

Source

Pathogen type

Antibiotic resistance

Outcome definition

Time point

% (n/N)

Reporting clinical cure or success

Case report and case series

 Pezzi et al., 2019 [24]

Case report

Maternal sepsis (not further specified)

E. coli: 100%, K. pneumonia: 100%a

–

–

–

100% (1/1)

 Jones et al., 2020 [27]

Case report

–

Pseudomonas: 100% (not further specified), E. coli: 100%

–

Defined as symptom resolution at the end of therapy, which was defined as documented subjective patient report of no complaints, distress, or disease-specific signs and/

or symptoms at follow-up outpatient physician clinic visits

–

100% (1/1)

 Sacha et al., 2017 [28]

Case series

Mixed infections: pneumonia, intra-abdominal, skin and soft tissue, primary bacteremia, bone and joint infection, pleural space infections

–

MDR infection: 40.4%, XDR infection: 25%, PDR infection: NR

–

–

77.8% (7/12)b

Case-control study

 Fernandez-Cruz et al., 2019 [29]

Case–control study

Bacteremia secondary n = 7, and primary n = 3

Pseudomonas: 100% (not further specified)

MDR infection: 50%, XDR infection: 50%

–

14 days

All patients: 80% (8/10)c,d

Monotherapy: 75.0% (3/4)c

Combination: 83.3% (5/6)c

Retrospective cohort studies

 Bassetti et al., 2019 [12]

Retrospective cohort

Mixed infections: nosocomial pneumonia, ABSSSI, cIAI, cUTI, bone infection and sepsis

Pseudomonas: 100% (not further specified)

–

Clinical cure or success was defined as complete resolution of clinical signs and symptoms related to P. aeruginosa infection and lack of microbiological evidence of infection

–

70.4% (19/27)

  Bassetti et al., 2019 [12]

Retrospective cohort

Mixed infections: nosocomial pneumonia, ABSSSI, cIAI, cUTI, bone infection and septic shock

Pseudomonas: 100% (not further specified)

–

Clinical cure or success was defined as complete resolution of clinical signs and symptoms related to P. aeruginosa infection and lack of microbiological evidence of infection

–

91.7% (11/12)

 Caston et al., 2017 [14]

Retrospective cohort

Overall mixed infections and sepsis/septic shock

Mixed hospital-acquired infections: Abdominal (N = 3), Respiratory (N = 6), Otitis and mastoiditis (N = 1), Biliary (N = 1), Venous Central Catheter (N = 1)

Pseudomonas: 100% (not further specified)

MDR infection: 100%

Clinical outcome considered a "cure" when attending physician observed a resolution of signs and symptoms and there were no radiologic findings of infection

30 days (after isolation of P. aeruginosa)

75.0% (9/12)

 Escola-Verge et al., 2018 [16]

Retrospective cohort

Mixed infections: lower respiratory tract, Soft tissue, Urinary tract, Bone, Intra-abdominal, BSI, Mediastinitis

Pseudomonas: 100% (not further specified), Enterobacter: 13.15%e

XDR infection: 100%f

Defined as resolution of signs and symptoms of the index infection at 90 days of follow-up

90 days

72.73% (8/11)

 Jayakumar et al., 2018 [10]

Retrospective cohort

Mixed infections: Respiratory, Blood, Urinary, Tissue, Wound (patients could have more than one infection)

Pseudomonas: 95% (not further specified)

• Polymicrobial Pseudomonas infection: Enterobacter (10%), Acinetobacter (10%), Providencia (5%),

• Meningosepheum (5%),

• Morganella (5%),

• Candida (14%)

K

Pneumoniae: 5%

MDR infection: 86%, all patients with Pseudomonas infections)

Documented microbiological eradication or discharge within 30 days from last C/T dose without death

30 days

77.0% (17/22)

30 days

57.0% (4/7)g

30 days

87.0% (13/15)h

 King et al., 2018 [11]

Retrospective cohort

Overall

Mixed infections: pneumonia, UTI, intra-abdominal, wound

Pseudomonas: 100% (not further specified)

MDR infection: 100%

Defined by improved symptoms, improved imaging where relevant and fever reduction

–

76.0% (19/25)

 Xipell et al., 2018 [22]

Retrospective cohort

Overall Mixed infections: submandibular fasciitis or UTI and deep surgical-site infection

–

MDR infection: 17.39%, XDR infection: 79%, PDR infection: 4%

–

–

50.0% (3/6)i

  1. ABSSSI Acute Bacterial Skin and Skin-structure infection, MDR Multi drug resistant, PDR Pan drug resistant, XDR Extensively drug resistant
  2. aThe presence of candida glabrata in the rectal pad was also found
  3. bAuthors note that 3 patients have primary bacteremia, 12 patients have concomitant bacteremia but then report outcomes on 12 patients with primary or concomitant bacteremia
  4. cThere were 10 cases (8, 80% achieved cure), 6 received combination therapy (5, 83.3% achieved cure), 4 received monotherapy (3, 75% achieved cure)
  5. dCases, combination or monotherapy, Combination therapy, 36.4% (12/10) (discrepancy in n/N from publication)
  6. e3 Enterococcus faecium, 2 Enterococcus faecalis
  7. fPrevious XDR-PA isolation 18 (47.4)
  8. gOther clinical success
  9. hRespiratory clinical success
  10. iN represents patients with either confirmed bacteremia, septic shock, or positive blood culture