# Prescribing Patterns and Clinical Outcomes of Ceftolozane/Tazobactam by Renal Function and Body Mass Index: A SPECTRA Real-World Multi-Country Analysis

## TL;DR

This study examines how ceftolozane/tazobactam performs in patients with kidney issues and obesity, showing it is effective in real-world settings.

## Contribution

The study provides real-world evidence of ceftolozane/tazobactam's effectiveness in patients with renal dysfunction and obesity, who are often underrepresented in clinical trials.

## Key findings

- Clinical success rates ranged from 59.1% to 77.8% across different renal function strata.
- Mortality rates varied between 11.1% and 29.2% depending on renal function and weight categories.
- Readmission rates were 4.5–11.8% across renal function and weight subgroups.

## Abstract

Background: Antimicrobial resistance is a global health crisis associated with high mortality and economic burden. Patients with renal dysfunction and obesity have increased susceptibility to infections and may experience different real-world outcomes, including clinical success and mortality, but are often under-represented in clinical trials. Ceftolozane/tazobactam (C/T) is an innovative therapy used to treat resistant Gram-negative infections. We aimed to describe real-world clinical outcomes in hospitalized adults treated with C/T across categories of renal function and BMI in the SPECTRA study. Methods: SPECTRA was a multi-national observational study on 617 patients who received C/T for ≥48 h. Outcomes included clinical success, all-cause in-hospital mortality, readmission, and ICU admission and length of stay (LOS), with sub-analysis of patients across BMI and renal function strata. Results: Renal function and weight were reported in 597 and 469 patients, respectively, of which 51.9% had lower creatine clearance (<80 mL/min) and 50.7% were overweight. Clinical success and all-cause in-hospital mortality ranged at 59.1–77.8% and 11.1–29.2% across renal function strata and 64.6–68.6% and 18.6–21.4% across weight subgroups. Across renal function and weight subgroups, 38.9–54.2% and 45.9–53.5% of patients were admitted to ICU. Median ICU LOS was 8–21.5 and 14–20 days, respectively. Readmission (30-day all-cause) occurred in 4.5–11.8% and 8.2–11.9% of patients across renal function and weight strata. Conclusions: Results from this sub-analysis suggest real-world clinical effectiveness of C/T across patients with renal impairment and obesity, highlighting C/T as a component within treatment guidelines for resistant Gram-negative infections.