Dados do Trabalho

Título

Critical Infection in Oncologic Children: What is the role of Ceftazidime-Avibactam ? Epidemiologic Analysis from a Single Center in Brazil

Introdução

Ceftazidime-avibactam (CAZ-AVI) plays an important role in multidrug resistant gram negative bacilli (MDR GNB) infection. In pediatrics caz/avi is indicated to urinary tract infection or intra abdominal infection with scarce data aiming at children with cancer with complicated gram negative bacilli infections.

Objetivo

This study aims to describe the use of caz-avi in GNB infection in children with câncer.

Método

Methods: Retrospective study conducted at the Pediatric Oncology Institute (IOP/GRAACC/UNIFESP) including infection due GNB occurring in pediatric oncology patients that received caz/avi

Resultados

From jan/2021 to jun/2022 11 patients were included deriving 13 episodes. 45% was female, median age of 7 years. 3 patients had ALL, 3 AML, 2 NHL and 1 meduloblastoma, fibrossarcoma and craniofaringioma each. The major CAZ-AVI prescription reason was MDR GNB infection or clinical failure to initial therapy. Episodes were defined as 6 BSI, 2 ITUs, 2 tracheobronchitis, 1 necrotizing pneumonia, 1 ventriculitis e 1 endocarditis. Identified pathogen was Klebsiella pneumoniae, Pseudomonas spp. , Enterobacter cloacae e Stenotrophomonas maltophilia. All episodes had important risk factors to MDR BGN, including neutropenia and HSCT. The median prescription length was 9 days and combined scheme was used in 8 episodes. The microbiological sterilization was achieved in 92% episodes, 30 days survival rate was 84%. No death was associated with treatment failure and no adverse events were associated to CAZ-AVI.

Conclusão

CAZ-AVI is a secure and effective option in GNB in oncologic pediatric patients.