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Tesi etd-05142020-164658


Thesis type
Tesi di laurea magistrale LM6
Author
GALFO, VALENTINA
URN
etd-05142020-164658
Title
Correlation between pharmacokinetics and clinical response to ceftazidime-avibactam plus aztreonam in patients with NDM-producing Klebsiella pneumoniae invasive infections
Struttura
RICERCA TRASLAZIONALE E DELLE NUOVE TECNOLOGIE IN MEDICINA E CHIRURGIA
Corso di studi
MEDICINA E CHIRURGIA
Supervisors
relatore Prof. Menichetti, Francesco
correlatore Dott. Falcone, Marco
Parole chiave
  • pharmacokinetic
  • aztreonam
  • ceftazidime-avibactam
  • NDM
Data inizio appello
09/06/2020;
Consultabilità
Secretata d'ufficio
Data di rilascio
09/06/2090
Riassunto analitico
Infections caused by Carbapenem resistant Enterobacteriaceae (CRE) are extremely frequent in worldwide hospitals, new antibiotic approaches are under studies, in particular the use of combination of aztreonam (ATM) with ceftazidime-avibactam (CAZ-AVI) is supported by in vitro data and a few clinical studies. No data have been published on pharmacokinetic, exception made for a single pediatric case report. The aim of this thesis is to compare the pharmacokinetic and the clinical response of patients treated with CAZ-AVI plus ATM with two different schemes of infusion.
41 patients with invasive infections caused by NDM-producing bacteria have been included in our study, sixteen have been treated with intermittent infusion, while twenty-five patients were treated with continuous infusion. Clinical and pharmacological information have been evaluated, blood samples have been collected between the 4th and 5th dose of antibiotic, in order to evaluate circulating concentrations, antibiotic clearance and distribution in central and peripheral compartment.
The two groups have been compared according to different clinical and hematological characteristics among those the SOFA score, ward of hospitalization and burns showed to be significantly different.
PK parameters have been corelated with clinical outcomes according to clinical characteristics of our patients. More in particular septic shock versus patients without septic shock; patients in intensive care (ICU) versus not-ICU patients; survivors versus not-survivors; burned versus not burned patients.
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