Clinical efficacy and influencing factors of ceftazidime and avibactam monotherapy versus combination therapy in the treatment of CRGNB infection

LIU Changwei; WANG Xiaohua; ZHANG Hui; WANG Ranran; XIAO Rongcheng; FANG Ling

doi:10.6039/j.issn.1001-0408.2025.16.13

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Clinical efficacy and influencing factors of ceftazidime and avibactam monotherapy versus combination therapy in the treatment of CRGNB infection

更新时间：2025-09-25

- Clinical efficacy and influencing factors of ceftazidime and avibactam monotherapy versus combination therapy in the treatment of CRGNB infection
- ZHONGGUO YAOFANG Vol. 36, Issue 16, Pages: 2030-2034(2025)
- 作者机构：
  
  1.安徽医科大学第一附属医院药剂科，合肥　230022
  2.国家中医药管理局中药化学三级实验室，合肥　230022
  3.安徽医科大学第一附属医院感染科，合肥　230022
- 作者简介：
- 基金信息：
- DOI：10.6039/j.issn.1001-0408.2025.16.13
  CLC： R978.1+1
- Received：11 March 2025，
  
  Revised：2025-07-25，
  
  Accepted：25 July 2025，
  
  Published：30 August 2025
- 稿件说明：
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刘昌伟,王小华,张慧,等.头孢他啶阿维巴坦单药对比联合疗法用于碳青霉烯类耐药革兰氏阴性菌感染的疗效及影响因素[J].中国药房,2025,36(16):2030-2034.

LIU Changwei,WANG Xiaohua,ZHANG Hui,et al.Clinical efficacy and influencing factors of ceftazidime and avibactam monotherapy versus combination therapy in the treatment of CRGNB infection[J].ZHONGGUO YAOFANG,2025,36(16):2030-2034.
刘昌伟,王小华,张慧,等.头孢他啶阿维巴坦单药对比联合疗法用于碳青霉烯类耐药革兰氏阴性菌感染的疗效及影响因素[J].中国药房,2025,36(16):2030-2034. DOI： 10.6039/j.issn.1001-0408.2025.16.13.

LIU Changwei,WANG Xiaohua,ZHANG Hui,et al.Clinical efficacy and influencing factors of ceftazidime and avibactam monotherapy versus combination therapy in the treatment of CRGNB infection[J].ZHONGGUO YAOFANG,2025,36(16):2030-2034. DOI： 10.6039/j.issn.1001-0408.2025.16.13.

摘要

目的

比较头孢他啶阿维巴坦（CZA）单药与联合疗法用于碳青霉烯类耐药革兰氏阴性菌（CRGNB）感染的疗效，并分析其影响因素。

方法

回顾性收集2020年1月至2025年3月在我院接受CZA治疗的CRGNB感染的患者资料，按用药的不同分为CZA单药组（52例）与CZA联合组（85例）。比较两组患者的疗效，记录分离菌株的药敏试验结果；采用多因素Logistic回归模型分析影响CRGNB感染患者临床疗效的因素。

结果

CZA联合组患者的细菌清除率显著高于CRZ单药组（

＝0.012），但两组患者的30 d病死率及临床有效率比较，差异均无统计学意义（

＞0.05）。耐碳青霉烯类肺炎克雷伯菌对替加环素敏感率最高（87.3%），耐碳青霉烯类铜绿假单胞菌对阿米卡星的敏感率为90.9%；5株分离菌株对CZA耐药。多因素Logistic回归分析结果显示，发生肺部感染、接受连续性肾脏替代治疗（CRRT）、疗程不足与临床治疗失败显著相关（

＜0.05）。

结论

CZA联合疗法与单药治疗CRGNB感染的临床有效率相当，但联合疗法的细菌清除率更高。发生肺部感染、接受CRRT以及疗程不足是临床治疗失败的独立危险因素。

Abstract

OBJECTIVE

To compare the efficacy of ceftazidime and avibactam （CZA） monotherapy and combination therapy in the treatment of carbapenem-resistant Gram-negative bacteria （CRGNB） infections， and analyze the influencing factors.

METHODS

The data of patients with CRGNB infection who received CZA treatment from January 2020 to March 2025 were collected retrospectively. The patients were divided into the CZA monotherapy group （52 cases） and the CZA combination therapy group （85 cases） according to treatment regimen. The therapeutic effects of the two groups were compared， and the drug susceptibility results of isolated strains were recorded. The multivariate Logistic regression model was used to analyze the factors influencing clinical efficacy of CRGNB patients.

RESULTS

The bacterial clearance rate of patients was significantly higher in the CZA combination therapy group than in the CZA mon

otherapy group （

＝0.012）. However， when comparing the 30-day mortality rate and the clinical response rate between the two groups， no statistically significant differences were observed （

＞0.05）. Among the isolates， carbapenem-resistant

Klebsiella pneumoniae

had the highest sensitivity to tigecycline （87.3%） and carbapenem-resistant

Pseudomonas aeruginosa

showed 90.9% sensitivity to amikacin. Five isolates were resistant to CZA. The multivariate Logistic regression showed， lung infection， receiving continuous renal replacement therapy （CRRT）， and inadequate treatment courses were significantly correlated with clinical treatment failure （

＜0.05）.

CONCLUSIONS

For CRGNB infection， the clinical efficacy of CZA combination therapy is similar to that of monotherapy， but the combination therapy has a higher bacterial clearance rate. Lung infections， receiving CRRT and inadequate treatment courses are independent risk factors for clinical treatment failure.

关键词

Keywords

references

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