Comparative Outcomes of Meropenem–Vaborbactam vs. Ceftazidime–Avibactam Among Adults Hospitalized with an Infectious Syndrome in the US, 2019–2021
<b>Background/Objectives</b>: Meropenem–vaborbactam (MEV) and ceftazidime–avibactam (CZA) are active against “urgent threat” pathogens like carbapenem-resistant Enterobacterales (CRE). However, few studies have compared outcomes between them. <b>Methods</b>: To explore compar...
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MDPI AG
2025-01-01
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| author | Marya D. Zilberberg Brian H. Nathanson Mark A. Redell Kate Sulham Andrew F. Shorr |
| author_facet | Marya D. Zilberberg Brian H. Nathanson Mark A. Redell Kate Sulham Andrew F. Shorr |
| author_sort | Marya D. Zilberberg |
| collection | DOAJ |
| description | <b>Background/Objectives</b>: Meropenem–vaborbactam (MEV) and ceftazidime–avibactam (CZA) are active against “urgent threat” pathogens like carbapenem-resistant Enterobacterales (CRE). However, few studies have compared outcomes between them. <b>Methods</b>: To explore comparative outcomes of MEV vs. CZA, we conducted a multicenter retrospective cohort study of all adult hospitalized patients with a serious infection (sepsis, urinary tract infection [UTI], complicated intraabdominal [cIAI] infection, or pneumonia) within the PINC AI Database, 2019–2021. Descriptive statistics compared the two groups along demographic and clinical characteristics, and multiple regression derived adjusted outcomes. <b>Results</b>: Among 1,989,765 patients who met enrollment criteria, 455 received MEV and 2320 CZA. Compared to CZA, patients on MEV were more commonly Caucasian (68.1% vs. 63.6%, <i>p</i> = 0.032) or Hispanic (21.8% vs. 12.8%, <i>p</i> < 0.001). Their mean [SD] Charlson comorbidity scores did not differ (3.6 [2.5] vs. 3.5 [2.5], <i>p</i> = 0.403). The most common index infection in both groups was pneumonia, though it was less prevalent in the MEV- than the CZA-treated group (48.1% vs. 56.8%, <i>p</i> = 0.001). Fewer than one-third of all patients received the respective drug within 2 days of the onset of the index infection (30.6% MEV vs. 33.0% CZA, <i>p</i> = 0.313). Fewer patients on MEV than CZA required mechanical ventilation (35.0% vs. 41.4%, <i>p</i> = 0.010). MEV treatment was associated with lower adjusted mortality (17.0% [95% CI 13.6%, 20.3%] vs. 20.6% [95% CI 19.0%, 22.2%], <i>p</i> = 0.048) relative to CZA. <b>Conclusions</b>: In this cohort of hospitalized patients treated with either MEV or CZA for their infectious syndrome, MEV was associated with lower adjusted hospital mortality, although the confidence intervals around the values overlapped. |
| format | Article |
| id | doaj-art-acc26593d93b464ea4ea4d709aa7367d |
| institution | Kabale University |
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| language | English |
| publishDate | 2025-01-01 |
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| series | Antibiotics |
| spelling | doaj-art-acc26593d93b464ea4ea4d709aa7367d2025-01-24T13:18:37ZengMDPI AGAntibiotics2079-63822025-01-011412910.3390/antibiotics14010029Comparative Outcomes of Meropenem–Vaborbactam vs. Ceftazidime–Avibactam Among Adults Hospitalized with an Infectious Syndrome in the US, 2019–2021Marya D. Zilberberg0Brian H. Nathanson1Mark A. Redell2Kate Sulham3Andrew F. Shorr4EviMed Research Group, LLC, Goshen, MA 01032, USAOptiStatim, LLC, Longmeadow, MA 01116, USAMelinta Therapeutics, Parsippany, NJ 07054, USAMelinta Therapeutics, Parsippany, NJ 07054, USAWashington Hospital Center, Washington, DC 20010, USA<b>Background/Objectives</b>: Meropenem–vaborbactam (MEV) and ceftazidime–avibactam (CZA) are active against “urgent threat” pathogens like carbapenem-resistant Enterobacterales (CRE). However, few studies have compared outcomes between them. <b>Methods</b>: To explore comparative outcomes of MEV vs. CZA, we conducted a multicenter retrospective cohort study of all adult hospitalized patients with a serious infection (sepsis, urinary tract infection [UTI], complicated intraabdominal [cIAI] infection, or pneumonia) within the PINC AI Database, 2019–2021. Descriptive statistics compared the two groups along demographic and clinical characteristics, and multiple regression derived adjusted outcomes. <b>Results</b>: Among 1,989,765 patients who met enrollment criteria, 455 received MEV and 2320 CZA. Compared to CZA, patients on MEV were more commonly Caucasian (68.1% vs. 63.6%, <i>p</i> = 0.032) or Hispanic (21.8% vs. 12.8%, <i>p</i> < 0.001). Their mean [SD] Charlson comorbidity scores did not differ (3.6 [2.5] vs. 3.5 [2.5], <i>p</i> = 0.403). The most common index infection in both groups was pneumonia, though it was less prevalent in the MEV- than the CZA-treated group (48.1% vs. 56.8%, <i>p</i> = 0.001). Fewer than one-third of all patients received the respective drug within 2 days of the onset of the index infection (30.6% MEV vs. 33.0% CZA, <i>p</i> = 0.313). Fewer patients on MEV than CZA required mechanical ventilation (35.0% vs. 41.4%, <i>p</i> = 0.010). MEV treatment was associated with lower adjusted mortality (17.0% [95% CI 13.6%, 20.3%] vs. 20.6% [95% CI 19.0%, 22.2%], <i>p</i> = 0.048) relative to CZA. <b>Conclusions</b>: In this cohort of hospitalized patients treated with either MEV or CZA for their infectious syndrome, MEV was associated with lower adjusted hospital mortality, although the confidence intervals around the values overlapped.https://www.mdpi.com/2079-6382/14/1/29comparative outcomesmultidrug resistancehospitalizationoutcomesepidemiology |
| spellingShingle | Marya D. Zilberberg Brian H. Nathanson Mark A. Redell Kate Sulham Andrew F. Shorr Comparative Outcomes of Meropenem–Vaborbactam vs. Ceftazidime–Avibactam Among Adults Hospitalized with an Infectious Syndrome in the US, 2019–2021 Antibiotics comparative outcomes multidrug resistance hospitalization outcomes epidemiology |
| title | Comparative Outcomes of Meropenem–Vaborbactam vs. Ceftazidime–Avibactam Among Adults Hospitalized with an Infectious Syndrome in the US, 2019–2021 |
| title_full | Comparative Outcomes of Meropenem–Vaborbactam vs. Ceftazidime–Avibactam Among Adults Hospitalized with an Infectious Syndrome in the US, 2019–2021 |
| title_fullStr | Comparative Outcomes of Meropenem–Vaborbactam vs. Ceftazidime–Avibactam Among Adults Hospitalized with an Infectious Syndrome in the US, 2019–2021 |
| title_full_unstemmed | Comparative Outcomes of Meropenem–Vaborbactam vs. Ceftazidime–Avibactam Among Adults Hospitalized with an Infectious Syndrome in the US, 2019–2021 |
| title_short | Comparative Outcomes of Meropenem–Vaborbactam vs. Ceftazidime–Avibactam Among Adults Hospitalized with an Infectious Syndrome in the US, 2019–2021 |
| title_sort | comparative outcomes of meropenem vaborbactam vs ceftazidime avibactam among adults hospitalized with an infectious syndrome in the us 2019 2021 |
| topic | comparative outcomes multidrug resistance hospitalization outcomes epidemiology |
| url | https://www.mdpi.com/2079-6382/14/1/29 |
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