Retrospective Case Series Analysis of Clinical Outcomes Associated with Management of Severe Community Acquired Pneumonia Cases due to K. pneumoniae with CSE-1034
Reema Kashiva *
Department of Head Medicine, Noble Hospital, 153, Magarpatta City Road, Hadapsar, Pune, Maharashtra 411013, India
Danish Memon
Department of Head Medicine, Noble Hospital, 153, Magarpatta City Road, Hadapsar, Pune, Maharashtra 411013, India
Ram Agarwal
Department of Head Medicine, Noble Hospital, 153, Magarpatta City Road, Hadapsar, Pune, Maharashtra 411013, India.
*Author to whom correspondence should be addressed.
Abstract
Background: In India, the rapid emergence of multi-drug resistance among community acquired pneumonia (CAP) causing pathogens contributes to the seriousness of these infections and is currently a major treatment-related issue. The objective of this case series was to determine the clinical efficacy of antibiotic adjuvant entity (CSE-1034: Ceftriaxone+Sulbactam+EDTA) in severe CAP cases.
Methods: Severe CAP patients due to K. pneumoniae who were hospitalized and treated with CSE-1034 as monotherapy or combination therapy were screened and further analyzed. CSE-1034 therapy was started in all these subjects based on culture sensitivity (C/s) profile and continued or discontinued depending on clinical response.
Results: 25 K. pneumoniae culture-positive patients with mean age of 52 years were included in this case series. C/s profile has shown that pathogens isolated from all subjects were completely resistant to amikacin, cefazolin, ceftriaxone, pipericillin-tazobactam (pip-taz) and cefoperazone/sulbactam. Sensitivity pattern of CSE-1034 was 100% and meropenem was 85%. The C/s reports and clinical response to CSE-1034 were in concordance in 92% patients. 23/25 (92%) patients treated with CSE-1034 were cured with CSE-1034 monotherapy and 2/25 (8%) with CSE-1034+colistin combination therapy.
Conclusion: From this case series, it can be presumed that CSE-1034 can serve as effective replacement to BL/BLI combinations and appears to be effective drug for treatment of severe CAP cases.
Keywords: K. pneumonia, CSE-1034, multi-drug resistance, community acquired pneumonia.