Investigation on the use of ceftazidime-avibactam at a national hospital in Vietnam

OBJECTIVES: To assess the utilization of ceftazidime-avibactam at Thong Nhat Hospital, a national hospital in Vietnam. METHODS: A descriptive cross-sectional study was conducted using retrospective data from medical records of inpatients aged ≥ 18 years who received ceftazidime-avibactam for at least 2 days between January 2023 and March 2025 at Thong Nhat Hospital, Vietnam. The appropriateness of ceftazidime-avibactam use was evaluated based on Thong Nhat Hospital's antibiotic use guideline. The backward conditional method was used to identify factors associated with patient treatment outcomes. RESULTS: A total of 101 patients were included, with a median age of 78 years (68-86). Respiratory and bloodstream infections were the most common types, accounting for 84.15% and 44.55% of cases, respectively. Gram-negative bacteria comprised 76.05% of isolates, with Klebsiella pneumoniae (26.47%), Klebsiella aerogenes (18.50%) and Pseudomonas aeruginosa (10.50%) being the most frequent. The susceptibility rate to ceftazidime-avibactam was 71.43% for Klebsiella pneumoniae, 95.65% for Klebsiella aerogenes and 42.86% for Pseudomonas aeruginosa. OXA-48 was the most detected carbapenemase gene (37.84%). The overall appropriateness rate of ceftazidime-avibactam use was 70.30%. The treatment success rate was 39.60%. Treatment in the intensive care unit was associated with decreased treatment success, while comorbid heart failure showed a potential association. CONCLUSIONS: The treatment success rate with ceftazidime-avibactam in this study was relatively low. Continuous surveillance of microbiological profiles and antibiotic resistance, particularly to ceftazidime-avibactam, is essential to better guide the management of drug-resistant Gram-negative infections at the hospital.