Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSPGUIMARAES, ThaisNOUER, Simone A.MARTINS, Roberta C. R.V, Lauro Perdigao NetoMARTINS, Willames M. B. S.BARBOSA, Ana Clara NarcisoFERREIRA, Adriana L. P.COSTA, Silvia F.GALES, Ana C.2019-11-062019-11-062019ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, v.63, n.10, article ID e00528-19, 6p, 20190066-4804https://observatorio.fm.usp.br/handle/OPI/34026In this article, we report a case series of patients with infections caused by Enterobacteriales coresistant to carbapenems and polymyxins who were treated with ceftazidime/avibactam (CAZ-AVI) salvage therapy on a compassionate-use protocol. We enrolled 29 adult patients in 3 centers that had an infection due to a resistant microorganism and for whom the treatments available were considered ineffective, treated them with CAZ-AVI, and assessed clinical and microbiological cure at the end of treatment and all-cause mortality at 14 days and 30 days. The antimicrobial susceptibility profile was determined using broth microdilution, and total genomic DNA was sequenced. Twelve (41.4%) patients had bacteremia, and 48.3% (14/29) of the infections were treated with combination therapy. All strains were producers of KPC-2 and were susceptible to CAZ-AVI (MIC90, 1 mu g/ml). Clinical success was high (24/29 [82.7%; 95% confidence interval, 64.2 to 94.2%]), even for the bacteremic cases (75%). The 14-day and 30-day mortality rates were 9/29 (31%) and 15/29 (51.7%), respectively. The 14-day mortality rate for pneumonia was the same as that for bloodstream infections (33.3%) and although not significant, we found that patients with renal impairment that received adjusted doses of CAZ-AVI had high mortality (4/9 (44%); P = 0.22). We concluded that CAZ-AVI is an option for the treatment of severe infections due to difficult-to-treat drug-resistant Enterobacteriales.engrestrictedAccessCREEnterobacterialesKPC-Kpextensively drug resistantklebsiella-pneumoniaemortalityarticleCopyright AMER SOC MICROBIOLOGY10.1128/AAC.00528-19MicrobiologyPharmacology & Pharmacy1098-6596