{
  "abstract": "Background\n\nMultidrug-resistant (MDR) Gram-negative infections are challenging to treat in children, and polymyxin-based regimens are limited by toxicity. We evaluated the real-world use of ceftazidime-avibactam (CZA) as a potential polymyxin-sparing option for children with MDR Gram-negative infections.Methods\n\nWe conducted a single-center retrospective comparative cohort study at a tertiary hospital in Istanbul, Türkiye. Children aged < 18 years who received definitive therapy for microbiologically confirmed MDR Gram-negative infections between January 2022 and May 2024 were included. The primary outcome was 28-day all-cause mortality. Secondary outcomes included clinical response, documented microbiological clearance, acute kidney injury (AKI), drug-induced liver injury (DILI) and one-year all-cause mortality.Results\n\nForty-five children were included: 15 received CZA-based therapy and 30 received non-CZA regimens. Mechanical ventilation was required in 40/45 (88.9%) patients, reflecting a critically ill cohort. Steroid exposure within 30 days (46.7% vs. 6.7%; P = 0.003) and prior carbapenem exposure (93.3% versus 56.7%; P = 0.016) were more frequent in the CZA group. Clinical response (73.3% versus 73.3%; P = 1.000) and 28-day all-cause mortality (40.0% versus 40.0%; P = 1.000) were comparable between groups. Documented microbiological clearance, AKI and DILI did not differ significantly. Similar findings were observed in the CZA vs. meropenem plus colistin subgroup.Conclusions\n\nCZA-based therapy showed similar observed outcomes and no clear excess toxicity signal compared with heterogeneous non-CZA regimens, despite preferential use in children with greater recent antimicrobial exposure and clinical complexity. These findings support CZA as a feasible polymyxin-sparing option in selected children.",
  "abstract_shown": true,
  "affiliations": [
    "Division of Pediatric Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Marmara University, Fevzi Çakmak, Muhsin Yazıcıoğlu Street, No:10, Floor 6, Pendik, Istanbul, Türkiye.",
    "Division of Pediatric Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Marmara University, Fevzi Çakmak, Muhsin Yazıcıoğlu Street, No:10, Floor 6, Pendik, Istanbul, Türkiye. agulsenakkoc@gmail.com.",
    "Division of Pediatric Intensive Care Unit,Department of Pediatrics, Faculty of Medicine, Marmara University, Istanbul, Türkiye.",
    "Division of Pediatric Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Biruni University, Istanbul, Türkiye."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 13,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Sevgi Aslan Tuncay"
    },
    {
      "affs": [
        1
      ],
      "name": "Gulsen Akkoc"
    },
    {
      "affs": [
        2
      ],
      "name": "Ezgi Celikboya"
    },
    {
      "affs": [
        0
      ],
      "name": "Seyhan Yilmaz"
    },
    {
      "affs": [
        0
      ],
      "name": "Burcu Parlak"
    },
    {
      "affs": [
        0
      ],
      "name": "Pinar Canizci Erdemli"
    },
    {
      "affs": [
        0
      ],
      "name": "Aylin Dizi Isik"
    },
    {
      "affs": [
        0
      ],
      "name": "Didem Buyuktas Aytac"
    },
    {
      "affs": [
        0
      ],
      "name": "Meryem Cagla Abaci Capar"
    },
    {
      "affs": [
        2
      ],
      "name": "Ahmet Furkan Eser"
    },
    {
      "affs": [
        2
      ],
      "name": "Makbule Nilufer Yalindag Ozturk"
    },
    {
      "affs": [
        0,
        3
      ],
      "name": "Eda Kepenekli"
    },
    {
      "affs": [
        0
      ],
      "name": "Sevliya Ocal Demir"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/efjkdy81x94dt.bib",
  "cited_by": 0,
  "doi": "10.1186/s12879-026-14049-0",
  "fulltext_url": "https://europepmc.org/articles/PMC13688810",
  "id": "efjkdy81x94dt",
  "issns": [
    "1471-2334"
  ],
  "landing_url": "https://europepmc.org/article/MED/42919204",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "RC109-216"
    ],
    [
      "openalex",
      "1313|Antibiotic Resistance in Bacteria"
    ]
  ],
  "openalex": "W7170741881",
  "pdf_url": "https://europepmc.org/articles/PMC13688810?pdf=render",
  "pmcid": "PMC13688810",
  "pmid": "42919204",
  "published": "2026-07-01",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/efjkdy81x94dt.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:21:02Z",
      "native_id": "MED:42919204",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42919204"
    },
    {
      "first_seen": "2026-10-30T13:45:34Z",
      "native_id": "66a66779c2864414a8d39eedd1e25426",
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      "url": "https://doi.org/10.1186/s12879-026-14049-0"
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  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "lcc:RC109-216",
      "subfield": "infectious-disease"
    }
  ],
  "title": "Ceftazidime-avibactam as a polymyxin-sparing option for multidrug-resistant Gram-negative infections in children: a real-world comparative cohort study.",
  "title_text": "Ceftazidime-avibactam as a polymyxin-sparing option for multidrug-resistant Gram-negative infections in children: a real-world comparative cohort study.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:45:34Z",
  "url": "https://research.draconitic.com/paper/efjkdy81x94dt",
  "venue": "BMC infectious diseases",
  "versions": []
}