P-1074. Clinical Outcomes in Patients Hospitalized with Exacerbation of Chronic Respiratory Infections treated with Ceftolozane/Tazobactam: Results from SPECTRA
Authors: Yucel Emre , Soriano Alex , Paterson David , Thalhammer Florian , Kluge Stefan , Viale Pierluigi , Allen Mike , Akrich Brune , Zhou Yanbing , Yang Huina , Kaul Sundeep 
Published: January 2025

Abstract

Background
SPECTRA was a multicenter, observational study of 617 patients (pts) treated with ceftolozane/tazobactam (C/T), to inform the real-world clinical management of gram-negative infections.Table 1.Baseline Characteristics and Microbiology SampleBMI, body mass index; IQR, interquartile range; IV, intravenous; SD, standard deviation, MDR, multidrug-resistant.

Methods
Retrospective data for pts with an exacerbation of a chronic respiratory infection (CRI) were extracted from medical records &lt; 6 months from the index date, &lt; 30 days from the last dose of C/T, or until death as part of a subcategory analysis. Clinical success, all-cause in-hospital mortality (ACHM), mean length of stay (LOS) in intensive care unit (ICU), and 30-day all-cause re-admission were assessed.Table 2.Treatment OutcomesCI, confidence interval; C/T, ceftolozane/tazobactam; ICU, intensive care unit; IQR, interquartile range; MDR, multidrug-resistant; SD, standard deviation.

Results
Among 91 pts with CRI exacerbation, 98.9% (n=90/91) had ≥1 comorbidity (mean, 2.6; standard deviation [SD], 1.3), the most common of which was chronic pulmonary disease (81.3%, n=74/91; Table 1). Most pts with microbiology data had infection with multidrug-resistant Pseudomonas aeruginosa (80.3%, n=53/66; Table 1). Median C/T duration was 14.0 days (range: 3–37). Clinical success was seen in 79.1% of pts (n=72/91). Within 28 days of ending treatment, most pts (77.8%, n=56/72) did not require further treatment for the index infection, 81.9% (n=59/72) experienced resolution of CRI exacerbation, 12.1% (n=11/91) experienced microbiological eradication (Table 2). Median ICU LOS was 34.5 days (range: 3–58) in hospitalized pts (n=29). ACHM was 6.6% (n=6/91; 95% confidence interval [CI]: 2.5–13.8). The 30-day all-cause re-admission rate was 15.4% (n=14/91) and was infection-related in 7.7% of pts (n=7/91; Table 2).

Conclusion
This sub-analysis of the SPECTRA study highlights the clinical characteristics and outcomes of pts hospitalized with CRI exacerbations treated with C/T. The sub-analysis shows positive clinical outcomes of C/T treatment, with high rates of clinical success and resolution of CRI exacerbation. Most patients did not require further antibacterial therapy within 28 days of stopping C/T, achieved clinical stability, and were discharged from the hospital, ICU, or step-down unit.

Disclosures
Emre Yucel, PhD, Merck: I am a full time Merck Employee and own stocks in the retirement plan provided by Merck.|Merck: Stocks/Bonds (Public Company) David Paterson, bioMerieux: Grant/Research Support|bioMerieux: Honoraria|Merck: Advisor/Consultant|Merck: Grant/Research Support|Merck: Honoraria|Pfizer: Advisor/Consultant|Pfizer: Grant/Research Support|Pfizer: Honoraria|Shionogi: Grant/Research Support|Shionogi: Honoraria Florian Thalhammer, MD, MSD: Advisor/Consultant Stefan Kluge, Prof. Dr. med., Merck & Co: Advisor/Consultant|Merck & Co: Board Member Mike Allen, PhD, Merck: I am a full time Merck Employee and own stocks in the retirement plan provided by Merck.|Merck: Stocks/Bonds (Public Company) Brune Akrich, MD, Merck: I am a full time Merck Employee and own stocks in the retirement plan provided by Merck.|Merck: Stocks/Bonds (Public Company) Yanbing Zhou, PhD, Merck: I am a full time Merck Employee and own stocks in the retirement plan provided by Merck.|Merck: Stocks/Bonds (Public Company)