ORIGINAL RESEARCH article
Front. Cell. Infect. Microbiol.
Sec. Antibiotic Resistance and New Antimicrobial drugs
This article is part of the Research TopicPerspectives in Antibiotic Resistance and New Antimicrobial Drugs: 2025View all 6 articles
Efficacy of ceftazidime/avibactam versus other antimicrobial agents for treating multidrug-resistant Pseudomonas aeruginosa: a propensity-matched retrospective analysis
Provisionally accepted
- 1Jiangsu Health Vocational College, Nanjing, China
- 2Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital With Nanjing Medical University, Nanjing, China
- 3The Second Affiliated Hospital of Nanjing Medical University Department of Gastroenterology, Nanjing, China
- 4Department of Gastroenterology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
- 5Department of Information, The First Affiliated Hospital With Nanjing Medical University, Nanjing, China
- 6Department of Medical Informatics, Nanjing Medical University The School of Biomedical Engineering and Informatics, Nanjing, China
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Introduction. Multidrug-resistant Pseudomonas aeruginosa (MDRPA) is a life-threatening infection with limited treatment options. As a novel combination drug of cephalosporin and beta-lactamase inhibitor, ceftazidime/avibactam (CAZ/AVI) is not much used in clinical treatment of MDRPA infections. To fill in this knowledge gap, a single-centre real-world study was conducted. Methods. This single-centre retrospective observational study included MDRPA-infected patients treated with CAZ/AVI or other antimicrobial agents between January 2019 and April 2021. Propensity score-matched and binary logistic regression analysis was used to compare the clinical and microbiological efficacy between CAZ/AVI and other antimicrobial agents. Results. Totally 363 patients with MDRPA infection were enrolled, including 49 patients treated with CAZ/AVI and 314 patients treated with other antimicrobial agents. The CAZ/AVI group exhibited a reduced failure rate of clinical treatment (P = 0.012, OR = 0.381, 95% CI 0.180 - 0.807). Subgroup analysis showed single lung infection was a significant risk factor for clinical treatment failure in patients treated with other antimicrobial agents (P = 0.023, OR = 2.568, 95% CI 1.138 - 5.796). No significant discrepancy was observed in microbiological efficacy between the two groups (P = 0.159, OR = 0.587, 95% CI 0.280 - 1.232), or in clinical and microbiological efficacy between CAZ/AVI monotherapy and combination therapy. Conclusions. CAZ/AVI demonstrates superior clinical efficacy against MDRPA in comparison to other antimicrobial agents. However, the administration of CAZ/AVI as part of combination therapy does not provide any clear benefits over monotherapy. Patients with single pulmonary infection caused by MDRPA show better clinical efficacy with CAZ/AVI. Further larger studies are needed to substantiate our findings.
Keywords: Multidrug-resistant Pseudomonas aeruginosa, ceftazidime avibactam, Propensity score-matched, clinical efficacy, Microbiological efficacy, pulmonary infection
Received: 11 Jun 2025; Accepted: 25 Nov 2025.
Copyright: © 2025 Qian, Wei, Qin, Ji, Jing, Miao and Sun. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
ShuMei Miao
WenKui Sun
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