CARBAPENEM-RESISTANT GRAM-NEGATIVE BACTERIA AND CEFTAZIDIME/AVIBACTAM USE AT HAI PHONG INTERNATIONAL HOSPITAL, 2022-2024
Main Article Content
Abstract
Background: Ceftazidime/avibactam is a new-generation antibiotic used in the treatment of infections caused by carbapenem-resistant Gram-negative bacteria; however, due to its high treatment cost and reported antimicrobial resistance, monitoring and evaluation of its clinical use are necessary. Objectives: To describe the status of carbapenem-resistant Gram-negative bacteria and to analyse the appropriateness of ceftazidime/avibactam use at Hai Phong International Hospital during the period 2022–2024. Materials and methods: A retrospective descriptive study was conducted on 3,936 clinical specimens with positive cultures for Gram-negative bacteria and electronic medical record data of 14 patients with 18 courses of ceftazidime/avibactam treatment at study hospital from 1 January 2022 to 31 December 2024. Results: The most common Gram-negative pathogens were E. coli (58.16%), K. pneumoniae (11.51%) and P.aeruginosa (8.30%). E. coli exhibited a low rate of meropenem resistance, increasing from 0.34% in 2022 to 2.28% in 2024. In contrast, K. pneumoniae and P. aeruginosa showed higher meropenem resistance rates but a decreasing trend during the study period. Ceftazidime/avibactam was mainly prescribed for the treatment of respiratory, urinary tract and skin and soft tissue infections caused by multidrug-resistant Gram-negative bacteria, most commonly K. pneumoniae and P. aeruginosa. The median duration of antibiotic therapy was 10 (9–22) days. A total of 94.44% of treatment courses complied with recommendations regarding indication, dosage and administration; only one case of inappropriate dose adjustment according to renal function was recorded. Conclusion: The carbapenem resistance rates of common Gram-negative bacteria, including E. coli, K. pneumoniae and P.aeruginosa, at the hospital during 2022–2024 were relatively low but showed an increasing trend over time. Ceftazidime/avibactam was used relatively appropriately in the treatment of multidrug-resistant Gram-negative infections.
Keywords
ceftazidime/avibactam, carbapenem-resistant gram-negative bacteria, multidrug- resistant
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
References
2. Bộ Y tế. Quyết định số 5631/QĐ-BYT ngày 31 tháng 12 năm 2020 về Hướng dẫn thực hiện quản lý sử dụng kháng sinh trong bệnh viện. 2020.
3. Shields R.K., Chen L., Cheng S., Chavda K.D., Press E.G., et al. Emergence of ceftazidimeavibactam resistance due to plasmid-borne blaKPC-3 mutations during treatment of carbapenem-resistant Klebsiella pneumoniae infections. Antimicrob Agents Chemother. 2017.61(3),e02097-16, doi: 10.1128/AAC.02097-16.
4. Magiorakos A.P., Srinivasan A., Carey R.B., Carmeli Y., Falagas M.E., Giske C.G., et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect. 2012. 18(3), 268-281, doi: 10.1111/j.1469-0691.2011.03570.x.
5. David N.G., Henry F.C., Michael S.S., Andrew T.P., Helen W.B., Douglas B., et al. The sanford guide to antimicrobial therapy 2024. Antimicrobial Therapy Inc. 2024.
6. Cục Quản lý Dược – Bộ Y tế. Hướng dẫn sử dụng Zavicefta. 2025. https://dichvucong.dav.gov.vn/congbothuoc/index.
7. Merative Micromedex. Drug interactions, IV compatibility. 2025. https://www.micromedexsolutions.com/home/dispatch/.
8. Chanu Rhee, Michael K Mansour. Procalcitonin use in lower respiratory tract infections. 2025. https://www.uptodate.com/contents/procalcitonin-use-in-lower-respiratory-tract-infections.
9. Bộ Y tế. Báo cáo giám sát kháng kháng sinh tại Việt Nam năm 2020. 2023. https://amr.kcb.vn/wp-content/uploads/2024/01/Bao-cao-giam-sat-khang-khang-sinh-tai-VietNam-nam-2020.pdf.
10. Hồ Quang Minh, Võ Thị Thuý Nga, Hà Thị Cẩm Tú, Huỳnh Phương Thảo và cộng sự. Khảo sát hiệu quả sử dụng kháng sinh Ceftazidim/ avibactam trong điều trị nhiễm trùng bội nhiễm ở bệnh nhân COVID-19 tại Bệnh viện Nhiệt đới. Tạp chí truyền nhiễm Việt Nam. 2025. 1(49), 19-26, doi: 10.59873/vjid.v1i49.434.