MedPath

Retrospective Chart Review Study to Assess Characteristics, Treatment Outcomes and Resource Use of Adults Hospitalized for CAP and CSSTi Treated With Zinforo in Multiple Countries

Completed
Conditions
Community Acquired Pneumonia
Complicated Skin and Soft Tissue Infection
Interventions
Registration Number
NCT04198571
Lead Sponsor
Pfizer
Brief Summary

MULTINATIONAL Retrospective Chart Review Study to Assess the Characteristics, Treatment Outcomes and Resource Use Among Adult Patients Hospitalized for Community-Acquired Pneumonia (CAP) or Complicated Skin and Soft Tissue Infections (cSSTI) Treated with Zinforo® (ceftaroline fosamil) in a Usual Care Setting

Detailed Description

The overall study aim is to provide real world evidence (RWE) on the characteristics, clinical management, treatment outcomes and healthcare resource use of adult patients aged 18 years and older admitted to the hospital for CAP or cSSTI who received Zinforo® in a usual care setting in Europe and Latin America on or before 31-May-2019.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
317
Inclusion Criteria

Not provided

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Exclusion Criteria

Not provided

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Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Zinforo TreatedZinforo (ceftaroline fosamil)Only those Adults treated with this treatment for CAP or cSSTi
Primary Outcome Measures
NameTimeMethod
Number of Participants With Clinical ResponseDay 1 of Zinforo treatment till end of Zinforo treatment: up to maximum of 35 days for CAP; up to maximum of 60 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)

Clinical response in CAP was defined as participants demonstrating clinical stability (i.e., according to the Infectious Disease Society of America \[IDSA\] guidelines a temperature of less than or equal to (\<=) 37.8 degree Celsius, heart rate of \<=100 beats per minute, respiratory rate of \<=24 breaths per minute, systolic blood pressure of greater than or equal to (\>=) 90 millimeters of mercury (mmHg), oxygen saturation of \>=90%, and confusion/disorientation recorded as absent) and clinical improvement (i.e., improvement of at least 1 of 4 symptoms present at Baseline \[i.e., cough, dyspnea, pleuritic chest pain, sputum production\] with worsening of none). Clinical response in cSSTI participants was defined as \>=20% reduction from baseline infection area and cessation of spread measured by total infection area.

CAP Only: Time to Clinical ImprovementBaseline (before Day 1 of Zinforo treatment) till end of Zinforo treatment, up to maximum of 35 days [from the retrospective data evaluated in approximately 14 months of the study]

Clinical improvement was defined as improvement of at least 1 of 4 symptoms present at Baseline (i.e., cough, dyspnea, pleuritic chest pain, sputum production) with worsening of none. The time to clinical improvement was reported in this outcome measure.

Day of MIC Assessment Since Index HospitalizationFrom Day 1 of Index hospitalization till MIC assessment, any day till 102 days for CAP; any day till 162 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)

Day of MIC assessment since the index hospitalization was reported in this outcome measure. Index hospitalization was first hospitalization on or before May 31, 2019 where Zinforo was administered for the treatment of CAP or cSSTI.

Number of Participants With Medical Conditions Presented at Index HospitalizationAt index hospitalization admission (from the retrospective data evaluated in approximately 14 months of the study)

The number of participants who had any medical conditions at the time of index hospitalization were reported in this outcome measure. Medical conditions that were considered included Human Immunodeficiency Virus (HIV) infection, alcohol abuse, cancer/malignancy, cerebrovascular disease, chronic dialysis within the past 30 days, chronic obstructive pulmonary disease, chronic renal disease, congestive heart failure, decompensated cirrhosis, diabetes mellitus, immunosuppressive disease, influenza, injection drug use, end stage liver disease, peripheral vascular disease, respiratory disease or any other relevant condition(s) or disease(s) that required chronic drug treatment. Index hospitalization was first hospitalization on or before May 31, 2019 where Zinforo was administered for the treatment of CAP or cSSTI.

Time to Clinical ResponseDay 1 of Zinforo treatment till end of Zinforo treatment: up to maximum of 35 days for CAP; up to maximum of 60 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)

Clinical response in CAP was defined as participants demonstrating clinical stability (i.e., according to the IDSA guidelines a temperature of \<=37.8 degree Celsius, heart rate of \<=100 beats per minute, respiratory rate of \<=24 breaths per minute, systolic blood pressure of \>=90 mmHg, oxygen saturation of \>=90%, and confusion/disorientation recorded as absent) and clinical improvement (i.e., improvement of at least 1 of 4 symptoms present at Baseline (i.e., cough, dyspnea, pleuritic chest pain, sputum production) with worsening of none). Clinical response in cSSTI participants was defined as \>=20% reduction from baseline infection area and cessation of spread measured by total infection area.

Number of Participants With Clinical FailureDay 1 of Zinforo treatment till end of Zinforo treatment: up to maximum of 35 days for CAP; up to maximum of 60 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)

Clinical failure for both CAP and cSSTI was defined as any of the following: treatment modification due to adverse event (AE); drug-drug interaction; insufficient response (followed by switch); death due to index infection; death due to other cause; relapse or recurrence.

CAP Only: Time to Clinical StabilityDay 1 of Zinforo treatment till end of Zinforo treatment, up to maximum of 35 days (from the retrospective data evaluated in approximately 14 months of the study)

Clinical stability was defined according to the IDSA guidelines as temperature of \<=37.8 degree Celsius, heart rate of \<=100 beats per minute, respiratory rate of \<=24 breaths per minute, systolic blood pressure of \>=90 mmHg, oxygen saturation of \>=90%, and confusion/disorientation recorded as absent. The time to achieve clinical stability was reported in this outcome measure.

Number of Participants Who Achieved Clinical CureDay 1 of Zinforo treatment till end of Zinforo treatment: up to maximum of 35 days for CAP; up to maximum of 60 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)

Clinical cure for both CAP and cSSTI was defined as the resolution of clinical features or improvement status requiring no further antibiotic therapy. Participants who achieved clinical cure were reported in this outcome measure.

CAP: Number of Participants With Early Response Within 4 DaysWithin 4 days after treatment with Zinforo (from the retrospective data evaluated in approximately 14 months of the study)

Clinical response in CAP was defined as participants demonstrating clinical stability (i.e., according to the IDSA guidelines a temperature of \<=37.8 degree Celsius, heart rate of \<=100 beats per minute, respiratory rate of \<=24 breaths per minute, systolic blood pressure of \>=90 mmHg, oxygen saturation of \>=90%, and confusion/disorientation recorded as absent) and clinical improvement (i.e., improvement of at least 1 of 4 symptoms present at Baseline \[i.e., cough, dyspnea, pleuritic chest pain, sputum production\] with worsening of none). Participants with CAP who showed response within 4 days after treatment with Zinforo were reported in this outcome measure.

Time to Clinical CureDay 1 of Zinforo treatment till end of Zinforo treatment: up to maximum of 35 days for CAP; up to maximum of 60 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)

Clinical cure for both CAP and cSSTI was defined as the resolution of clinical features or improvement status requiring no further antibiotic therapy. Time taken to achieve the clinical cure was reported in this outcome measure.

cSSTI: Number of Participants According to Reasons for Clinical FailureDay 1 of Zinforo treatment till end of Zinforo treatment, up to maximum of 60 days (from the retrospective data evaluated in approximately 14 months of the study)

Clinical failure was defined as any of the following: treatment modification due to AE; drug-drug interaction; insufficient response (followed by switch); death due to index infection; death due to other cause; relapse or recurrence. Number of participants with cSSTI, according to the reasons for their clinical failure were reported in this outcome measure. Only those reasons which had at least 1 participant has been reported.

cSSTI Only: Time to Greater Than or Equal to (>=) 20% Reduction From Baseline in Infection AreaBaseline (before Day 1 of treatment) till end of treatment, up to maximum of 60 days [from the retrospective data evaluated in approximately 14 months of the study]

The response to treatment in cSSTI participants was measured as \>=20% reduction from baseline in infection area.

Number of Participants With Re-hospitalization Within 30 Days of DischargeWithin 30 days after discharge from hospital (discharge was any day till 102 days for CAP; any day till 162 days for cSSTI) [from the retrospective data evaluated in approximately 14 months of the study]

The number of participants who were re-hospitalized within 30 days of discharge were reported in this outcome measure.

Number of Participants With Invasive Major Surgical Treatment in the 3 Months Before the Index Hospitalization3 months prior to index hospitalization (from the retrospective data evaluated in approximately 14 months of the study)

The number of participants who had undergone surgical treatments, 3 months before to the index hospitalization were reported in this outcome measure.

Number of Participants According to Therapies Received in the 3 Months Before the Index Hospitalization3 months prior to index hospitalization (from the retrospective data evaluated in approximately 14 months of the study)

Number of participants according to therapies received in the 3 months prior to index hospitalization were reported in this outcome measure. One participant could receive more than one therapy.

CAP: Number of Participants According to Reasons for Clinical FailureDay 1 of Zinforo treatment till end of Zinforo treatment, up to maximum of 35 days (from the retrospective data evaluated in approximately 14 months of the study)

Clinical failure was defined as any of the following: treatment modification due to AE; drug-drug interaction; insufficient response (followed by switch); death due to index infection; death due to other cause; relapse or recurrence. Number of participants with CAP, according to the reasons for their clinical failure were reported in this outcome measure. Only those reasons which had at least 1 participant has been reported.

cSSTI: Number of Participants With Early Response Within 3 DaysWithin 3 days after treatment with Zinforo (from the retrospective data evaluated in approximately 14 months of the study)

Clinical response in cSSTI participants was defined as \>=20% reduction from baseline infection area and cessation of spread measured by total infection area. Participants with cSSTI who showed response within 3 days after treatment with Zinforo were reported in this outcome measure.

cSSTI Only: Time to Cessation of Spread Measured by Total Infection AreaDay 1 of Zinforo treatment till end of Zinforo treatment, up to maximum of 60 days (from the retrospective data evaluated in approximately 14 months of the study)

The response to treatment in cSSTI participants was measured as cessation of spread of infection measured by total infection area.

Number of Participants With Severe CAPAt index hospitalization admission (from the retrospective data evaluated in approximately 14 months of the study)

Number of participants diagnosed with severe CAP were reported in this outcome measure.

Number of Participants According to Microbiological CAP Diagnosis at Index HospitalizationAt index hospitalization admission (from the retrospective data evaluated in approximately 14 months of the study)

The number of participants were classified according to the various pathogens identified during CAP diagnosis in this outcome measure.

cSSTI: Number of Participants According to Type of Body Area Involved at Index HospitalizationAt index hospitalization admission (from the retrospective data evaluated in approximately 14 months of the study)

The number of participants were classified according to the body area involved in cSSTI are reported in this outcome measure. One participant could have more than one type of body area involvement.

cSSTI: Number of Participants According to Level of Infections at Index HospitalizationAt index hospitalization admission (from the retrospective data evaluated in approximately 14 months of the study)

The number of participants were classified according to the level of infections in this outcome measure.

cSSTI: Number of Participants According to Type of Diagnostic Tests Conducted at Index HospitalizationAt index hospitalization admission (from the retrospective data evaluated in approximately 14 months of the study)

The number of participants classified according to the diagnostic tests conducted to diagnose cSSTI were reported in this outcome measure. One participant could have more than one type of diagnostic test.

Number of Participants According to Class of Antibiotics Received Prior to Zinforo Treatment During Index HospitalizationBefore Zinforo treatment initiation during index hospitalization, index hospitalization was of 102 days for CAP; 162 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)

The number of participants were classified according to types of antibiotics that they received prior to Zinforo and reported in this outcome measure.

Number of Participants According to Lines of Pre-Zinforo Therapies During Index HospitalizationBefore Zinforo treatment initiation during index hospitalization, index hospitalization was of 102 days for CAP; 162 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)

The number of participants were classified according to the lines of therapy in this outcome measure.

cSSTI Only: Time to Cessation of Spread Measured by Infection Length and WidthDay 1 of Zinforo treatment till end of Zinforo treatment, up to maximum of 60 days (from the retrospective data evaluated in approximately 14 months of the study)

Time taken for the cessation of spread of infection as measured by length and width of the infected area was reported in this outcome measure.

Number of Participants With Serious Adverse EventsDay 1 of Zinforo treatment till end of Zinforo treatment: up to maximum of 35 days for CAP; up to maximum of 60 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)

An SAE was defined as any untoward medical occurrence at any dose that resulted in any of the following outcomes: death; life-threatening; hospitalization/prolongation of hospitalization; persistent/significant disability/incapacity; congenital anomaly/birth defect; or that was considered as an important medical event.

Number of Participants With Radiographic Findings in Tests for CAPAt index hospitalization admission (from the retrospective data evaluated in approximately 14 months of the study)

Participants were categorized according to radiographic findings in the tests conducted for diagnosis of CAP infection in this outcome measure. One participant could have more than one radiographic finding.

CAP: Number of Participants With Triggering Signs and Symptoms at Index HospitalizationAt index hospitalization admission (from the retrospective data evaluated in approximately 14 months of the study)

Participants were categorized according to triggering signs and symptoms at CAP diagnosis and recorded at index hospital admission were reported in this outcome measure. The observed signs and symptoms were dyspnea, tachypnea, or hypoxemia (oxygen \[O2\] saturation \< 90% on room air or partial pressure of oxygen (pO2) \< 60 mmHg), Fever (\>38 degree Celsius\[C\]oral; \> 38.5 degree C rectally or tympanically) or hypothermia (\< 35 degree C), White Blood Cell (WBC) count \> 10,000 cells/cubic millimeter(mm³) or \< 4,500 cells/mm³. One participant could have more than one signs or symptoms.

Number of Participants According to Discharge StatusAt discharge from hospital: any day till 102 days for CAP; any day till 162 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)

Participants were categorized based on the discharge status in this outcome measure.

Number of Participants According to Vital Status Within 30 Days of DischargeWithin 30 days after discharge from hospital (discharge was any day till 102 days for CAP; any day till 162 days for cSSTI) [from the retrospective data evaluated in approximately 14 months of the study]

The number of participants were classified according to the vital status in this outcome measure.

Number of Participants According to Minimum Inhibitory Concentration (MIC) AssessmentFrom 1 week before Zinforo treatment through 24 hours post discontinuation of Zinforo treatment during index hospitalization (102 days for CAP; 162 days for cSSTI) [from retrospective data evaluated in approximately 14 months of study]

MIC was defined as the lowest concentration of an antimicrobial that will inhibit the visible growth of a microorganism. Participants were categorized as Yes, No or Unknown against being assessed for MIC.

Number of Participants According to MIC of Antibacterial Drugs Assessed Based on PathogensFrom 1 week before Zinforo treatment through 24 hours post discontinuation of Zinforo treatment during index hospitalization (102 days for CAP; 162 days for cSSTI) [from retrospective data evaluated in approximately 14 months of study]

Pathogens for bacterial pneumonia were identified by blood, respiratory (e.g., sputum, bronchoalveolar lavage), or pleural effusion cultures and pathogens for cSSTI were identified blood or skin/soft tissue/bone/wound cultures. Number of participants with MIC of antibacterial drugs for pathogens isolated from samples were reported in this outcome measure.

Number of Participants With Hospitalization for Any Reason in the 3 Months Before the Index Hospitalization3 months prior to index hospitalization (from the retrospective data evaluated in approximately 14 months of the study)

The number of participants who had hospitalization for any reason, 3 months before the index hospitalization were reported in this outcome measure. Index hospitalization was first hospitalization on or before May 31, 2019 where Zinforo was administered for the treatment of CAP or cSSTI.

Number of Participants According to Type of Prognostic Scoring System Used to Assess CAP SeverityAt index hospitalization admission(from the retrospective data evaluated in approximately 14 months of the study)

In this outcome measure participants were categorized according to type of assessment used to assess CAP severity. Pneumonia severity index (PSI)/PORT score was used to calculate the probability of morbidity and mortality among participants with CAP. The score was used to predict the need for hospitalization in people with pneumonia. CURB- 65 was used to measure the confusion, blood urea, respiratory rate, blood pressure for the participants aged greater than or equal to 65 years. Multiple criteria to assess the severity of CAP exist. In this study severity was first globally assessed asking if a (any) criterion for severity of CAP would apply. In subsequent questions the details on the exact methods of the severity assessment were then asked. This included the information about PORT score / PSI, CURB-65 and recurrency of CAP.

Time of CAP Diagnosis at Index HospitalizationAt index hospitalization admission (from the retrospective data evaluated in approximately 14 months of the study)

The time taken (in days) taken to diagnose CAP in the participants prior to index hospitalization were reported in this outcome measure and this data was recorded at index hospitalization admission.

Number of Participants With Recurrent CAP Infections at Index HospitalizationAt index hospitalization admission (from the retrospective data evaluated in approximately 14 months of the study)

The number of participants with recurrent CAP infections were reported in this outcome measure.

Number of Participants According to Type of Investigation Performed for Positive Microbiological CAP Diagnosis at Index HospitalizationAt index hospitalization admission (from the retrospective data evaluated in approximately 14 months of the study)

The number of participants were classified according to the type of investigations performed for the microbiological CAP diagnosis and were reported in this outcome measure.

CAP: Number of Participants According to Influenza Vaccination Status During 12 Months Prior to Index Hospitalization12 months prior to index hospitalization (from the retrospective data evaluated in approximately 14 months of the study)

The number of participants according to the status of influenza vaccination were reported in this outcome measure, as vaccinated: Yes, No and Unknown.

CAP: Number of Participants According to Pneumococcal Vaccination Status at Index HospitalizationAt index hospitalization admission (from the retrospective data evaluated in approximately 14 months of the study)

The number of participants according to the status of pneumococcal vaccination were reported in this outcome measure.

Time of cSSTI Diagnosis at Index HospitalizationAt index hospitalization admission (from the retrospective data evaluated in approximately 14 months of the study)

The time taken (in days) taken to diagnose cSSTI in the participants prior to index hospitalization were reported in this outcome measure and this data was recorded at index hospitalization admission.

Number of Participants According to Systemic Signs of cSSTI at Index HospitalizationAt index hospitalization admission (from the retrospective data evaluated in approximately 14 months of the study)

The number of participants were classified according to the systemic signs observed Including temperature greater than (\>) 30 degree Celsius, White blood cell count \>10,000 cells per millimeter cube(/mm3) or \<4,500/mm3 or immature neutrophils \>10%, septic shock, organ dysfunction and none of the above mentioned were reported. One participant could have more than one systemic sign.

Duration of Pre-Zinforo Treatment During Index HospitalizationBefore Zinforo treatment initiation during index hospitalization, index hospitalization was of 102 days for CAP; 162 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)
CAP: Number of Participants With Polymerase Chain Reaction (PCR) Determination of H1N1 Influenza Virus at Index HospitalizationAt index hospitalization admission (from the retrospective data evaluated in approximately 14 months of the study)

In this outcome measure number of participants who had H1N1 Influenza virus determined using PCR were reported.

CAP: Number of Participants According to the Biomarkers Used for Monitoring Clinical Evolution at Index HospitalizationAt index hospitalization admission (from the retrospective data evaluated in approximately 14 months of the study)

The number of participants were classified according to the biomarkers used for monitoring the state of CAP in this outcome measure.

cSSTI: Number of Participants With Recurrent Infection at Index HospitalizationAt index hospitalization admission (from the retrospective data evaluated in approximately 14 months of the study)

The number of participants that had recurrent cSSTI infections were reported in this outcome measure.

cSSTI: Number of Participants According to Type of Lesions Involved at Index HospitalizationAt index hospitalization admission (from the retrospective data evaluated in approximately 14 months of the study)

The number of participants classified according to the types of lesions involved in the cSSTI infection were reported in this outcome measure. One participant could have more than one type of lesion.

cSSTI: Number of Participants According to Area of Extension of Skin Infection at Index HospitalizationAt index hospitalization admission (from the retrospective data evaluated in approximately 14 months of the study)

The number of participants were classified according to the extent of skin that was affected with the infection in this outcome measure.

Time From Symptom Onset to First Dose of Pre-Zinforo TreatmentBefore Zinforo treatment initiation during index hospitalization, index hospitalization was of 102 days for CAP; 162 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)
Number of Doses Administered for Pre-Zinforo Treatment During Index HopsitalizationBefore Zinforo treatment initiation during index hospitalization, index hospitalization was of 102 days for CAP; 162 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)
Number of Participants With Pre-Zinforo Treatment Modification During Index HospitalizationBefore Zinforo treatment initiation during index hospitalization, index hospitalization was of 102 days for CAP; 162 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)

The number of participants who had pre-Zinforo treatment modification were reported in this outcome measure.

Number of Participants According to Reasons for Pre-Zinforo Treatment ModificationBefore Zinforo treatment initiation during index hospitalization, index hospitalization was of 102 days for CAP; 162 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)

The number of participants classified according to the reasons for pre-Zinforo treatment modification were reported in this outcome measure. One participant could have more than one reason for treatment modification. Index hospitalization was first hospitalization on or before May 31, 2019 where Zinforo was administered for the treatment of CAP or cSSTI. One participant could have more than one reason for treatment modification.

Time to Treatment Modification From Initial Dose of Pre-Zinforo TreatmentBefore Zinforo treatment initiation during index hospitalization, index hospitalization was maximum of 102 days for CAP; maximum of 162 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)

The time (days) taken for modification from initial dose of pre-Zinforo treatment were reported in this outcome measure.

cSSTI: Number of Participants According to Type of Anatomical Structures Affected at Index HospitalizationAt index hospitalization admission (from the retrospective data evaluated in approximately 14 months of the study)

The number of participants were classified according to the anatomical structures involved in the infections in this outcome measure.

cSSTI: Number of Participants With Triggering Signs and Symptoms at Index HospitalizationAt index hospitalization admission (from the retrospective data evaluated in approximately 14 months of the study)

The number of participants with triggering signs and symptoms during the cSSTI diagnosis were reported in this outcome measure. One participant could have more than one triggering signs and symptoms.

cSSTI: Number of Participants According to Microbiologic Diagnosis at Index HospitalizationAt index hospitalization admission (from the retrospective data evaluated in approximately 14 months of the study)

Pathogens identified by blood or skin/soft tissue/bone/wound cultures were recorded for participants with cSSTI.

Number of Participants According to Routes of Administration for Pre-Zinforo Treatment During Index HospitalizationBefore Zinforo treatment initiation during index hospitalization, index hospitalization was of 102 days for CAP; 162 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)

The number of participants were classified according to various routes of administration for pre-Zinforo treatment and were reported in this outcome measure.

Number of Participants According to Types of Pre-Zinforo Treatment During Index HospitalizationBefore Zinforo treatment initiation during index hospitalization, index hospitalization was of 102 days for CAP; 162 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)

The number of participants were classified according to types of Pre-Zinforo treatment and were reported in this outcome measure. One participant could have more than one type of pre-Zinforo treatment.

Time From Symptom Onset to First Dose of Zinforo During Index HospitalizationDuring index hospitalization, index hospitalization was maximum of 102 days for CAP; maximum of 162 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)

The time taken for the symptom onset to the administration of first dose of Zinforo was reported in this outcome measure.

Number of Participants According to Types of Treatment for ZinforoDuring index hospitalization, index hospitalization was maximum of 102 days for CAP; maximum of 162 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)

The number of participants classified according to the types of treatment for Zinforo were reported in this outcome measure. Types included empiric, definitive/specific and unknown. Empiric was defined as therapy administered to participants prior to the results of blood culture and susceptibility tests. Definitive was defined as therapy administered after the test results were received.

Number of Participants According to Locations of Zinforo AdministrationDay 1 of Zinforo treatment till end of Zinforo treatment, during index hospitalization, index hospitalization was maximum of 102 days for CAP; maximum of 162 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)

The number of participants were classified according to the locations where Zinforo was administered were reported in this outcome measure. One participant could have more than one location of Zinforo administration.

Number of Participants Administered Zinforo as Monotherapy or Combination TherapyDay 1 of Zinforo treatment till end of Zinforo treatment, during index hospitalization, index hospitalization was maximum of 102 days for CAP; maximum of 162 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)

The number of participants were classified according to Zinforo administration as monotherapy or combination therapy were reported in this outcome measure.

Number of Doses Administered for Post Zinforo TreatmentPost Zinforo treatment, during index hospitalization, index hospitalization was maximum of 102 days for CAP; maximum of 162 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)
Number of Participants Based on Treatment Response to Pre-Zinforo Treatment During Index HospitalizationBefore Zinforo treatment initiation during index hospitalization, index hospitalization was of 102 days for CAP; 162 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)

Treatment response was defined according to the following criteria: CAP participants who demonstrated clinical stability (defined according to the Infectious Diseases Society of America \[IDSA\] guidelines as temperature of ≤37.8 C°, heart rate of ≤100 beats/min, respiratory rate of ≤24 breaths/min, systolic blood pressure of ≥90mmHg, oxygen saturation of ≥90%, and confusion/disorientation recorded as absent) and clinical improvement{defined as improvement of at least 1 of 4 symptoms present at baseline (i.e., cough, dyspnea, pleuritic chest pain, sputum production) with worsening of none}. cSSTI participants: ≥20% reduction from baseline infection area and cessation of spread measured by total infection area. The number of participants were classified according to treatment response to pre-Zinforo treatment and were reported in this outcome measure.

Duration of Zinforo Treatment During Index HospitalizationDay 1 of Zinforo treatment till end of Zinforo treatment, during index hospitalization, index hospitalization was maximum of 102 days for CAP; maximum of 162 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)

The duration of Zinforo treatment for CAP and cSSTI infections were reported in this outcome measure.

Daily Dose of ZinforoDay 1 of Zinforo treatment till end of Zinforo treatment, during index hospitalization, index hospitalization was maximum of 102 days for CAP; maximum of 162 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)
Number of Participants According to Lines of Therapy for Post-Zinforo TreatmentPost Zinforo treatment, during index hospitalization, index hospitalization was maximum of 102 days for CAP; maximum of 162 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)

The number of participants were classified according to the lines of therapy for post-Zinforo treatment were reported in this outcome measure.

Duration From Zinforo Discontinuation to Initiation of New TreatmentPost Zinforo treatment, during index hospitalization, index hospitalization was maximum of 102 days for CAP; maximum of 162 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)

The duration in days from Zinforo treatment discontinuation to initiation of new treatment were reported in this outcome measure.

Number of Participants Who Achieved Clinical Response to Post-Zinforo TreatmentPost Zinforo treatment, during index hospitalization, index hospitalization was maximum of 102 days for CAP; maximum of 162 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)

Clinical response in CAP was defined as participants demonstrating clinical stability (i.e., according to the IDSA guidelines a temperature of \<=37.8 degree Celsius, heart rate of \<=100 beats per minute, respiratory rate of \<=24 breaths per minute, systolic blood pressure of \>=90 mmHg, oxygen saturation of \>=90%, and confusion/disorientation recorded as absent) and clinical improvement (i.e., improvement of at least 1 of 4 symptoms present at Baseline (i.e., cough, dyspnea, pleuritic chest pain, sputum production) with worsening of none). Clinical response in cSSTI participants was defined as \>=20% reduction from baseline infection area and cessation of spread measured by total infection area.

Duration of Index HospitalizationDay 1 of admission of index hospitalization to discharge from hospital (from the retrospective data evaluated in approximately 14 months of the study)

Index hospitalization was first hospitalization on or before May 31, 2019 where Zinforo was administered for the treatment of CAP or cSSTI.

Total Number of Doses of Other Antibiotics Administered in Combination With ZinforoDay 1 of Zinforo treatment till end of Zinforo treatment, during index hospitalization, index hospitalization was maximum of 102 days for CAP; maximum of 162 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)
Total Dose of Other Antibiotics Administered Post Zinforo TreatmentPost Zinforo treatment, during index hospitalization, index hospitalization was maximum of 102 days for CAP; maximum of 162 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)
Number of Participants With Insufficient Response to Pre-Zinforo Treatment During Index HospitalizationBefore Zinforo treatment initiation during index hospitalization, index hospitalization was maximum of 102 days for CAP; maximum of 162 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)

The number of participants with insufficient response to pre-Zinforo treatment were reported in this outcome measure.

Time From Admission to First Dose of Zinforo During Index HospitalizationDay 1 of Zinforo treatment till end of Zinforo treatment, during index hospitalization, index hospitalization was maximum of 102 days for CAP; maximum of 162 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)

The time taken from admission to the administration of first dose of Zinforo was reported in this outcome measure.

Number of Participants Who Received Renal Replacement Therapy Post Initiating Treatment With ZinforoPost initiation of Zinforo treatment, during index hospitalization, index hospitalization was maximum of 102 days for CAP; maximum of 162 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)

The number of participants who received renal replacement therapy after initiating treatment with Zinforo were reported in this outcome measure.

Number of Participants Who Received Mechanical Ventilation, Oxygen Therapy and Parenteral NutritionDuring index hospitalization, index hospitalization was maximum of 102 days for CAP; maximum of 162 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)
Number of Infusions Administered Daily for ZinforoDay 1 of Zinforo treatment till end of Zinforo treatment, during index hospitalization, index hospitalization was maximum of 102 days for CAP; maximum of 162 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)
Number of Participants Receiving Concomitant Therapies Along With ZinforoDay 1 of Zinforo treatment till end of Zinforo treatment, during index hospitalization, index hospitalization was maximum of 102 days for CAP; maximum of 162 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)

Number of participants who received concomitant therapies along with Zinforo were reported in this outcome measure.

Number of Participants According to Reasons for Switching to Post-Zinforo TreatmentPost Zinforo treatment, during index hospitalization, index hospitalization was maximum of 102 days for CAP; maximum of 162 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)

The number of participants were classified according to the reasons for switching to post-Zinforo treatment were reported in this outcome measure. One participant could have more than one reason for switch.

Number of Participants According to Treatments Received During Index HospitalizationDuring index hospitalization, index hospitalization was maximum of 102 days for CAP; maximum of 162 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)

The number of participants were classified according to treatments received during index hospitalization were reported in this outcome measure.

Number of Participants Who Received Home-Based Care Through a Healthcare AgencyWithin 30 days post discharge from index hospitalization (from the retrospective data evaluated in approximately 14 months of the study)

The number of participants who received home-based care through a healthcare agency were reported in this outcome measure.

Duration of Re-hospitalizationsDay 1 of re-hospitalization till discharge (from the retrospective data evaluated in approximately 14 months of the study)

In this outcome measure, data is recorded for duration (in days) of re-hospitalization (if any) that happened within 30 days post discharge from index hospitalization.

Number of Participants With Development of Sepsis During Index HospitalizationDuring index hospitalization, index hospitalization was maximum of 102 days for CAP; maximum of 162 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)

The number of participants who developed sepsis during index hospitalization were reported in this outcome measure.

Number of Participants With Quick Sepsis-Related Organ Failure Assessment (qSOFA) ConductedDuring index hospitalization, index hospitalization was maximum of 102 days for CAP; maximum of 162 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)

The qSOFA (also known as quickSOFA) was a bedside prompt that identified participants with suspected infection who are at greater risk for a poor outcome outside the intensive care unit (ICU). It used three criteria, assigning one point for low blood pressure Systolic blood pressure less than or equal to 100 millimeters of mercury (SBP\<=100 mmHg), high respiratory rate greater than or equal to (\>=) 22 breaths per min, or altered mentation (Glasgow coma scale\<15).

Number of Participants Who Suffered Acute Renal Failure Necessitating Renal ReplacementDuring index hospitalization, index hospitalization was maximum of 102 days for CAP; maximum of 162 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)

The number of participants who suffered from acute renal failure and necessitated renal replacement were reported in this outcome measure.

Total Number of Doses of Zinforo AdministeredDay 1 of Zinforo treatment till end of Zinforo treatment, during index hospitalization, index hospitalization was maximum of 102 days for CAP; maximum of 162 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)
Number of Participants According to Type of Antibiotics Received for Index Infection After Zinforo TreatmentPost Zinforo treatment, during index hospitalization, index hospitalization was maximum of 102 days for CAP; maximum of 162 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)

The number of participants were classified according to types of antibiotics received for index infection (CAP and cSSTI) after the Zinforo treatment were reported in this outcome measure. One participant could receive more than one type of antibiotic.

Number of Participants According to Route of Administration for Post-Zinforo TreatmentCAP (up to maximum of 102 days), cSSTI (up to maximum of 162 days)

The number of participants were classified according to routes of administration for post-Zinforo treatment were reported in this outcome measure.

Number of Participants According to Reasons for Clinical Failure to Post-Zinforo TreatmentPost Zinforo treatment, during index hospitalization, index hospitalization was maximum of 102 days for CAP; maximum of 162 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)

Clinical failure for both CAP and cSSTI was defined as any of the following: treatment modification due to AE; drug-drug interaction; insufficient response (followed by switch); death due to index infection; death due to other cause; relapse or recurrence. The number of participants were classified according to the reasons for clinical failure post-Zinforo treatment were reported in this outcome measure.

Number of Participants With Re-hospitalizationsWithin 30 days post discharge from index hospitalization (from the retrospective data evaluated in approximately 14 months of the study)

The number of participants who had re-hospitalizations were reported in this outcome measure.

Number of Participants Based on Treatment Response to Post-Zinforo TreatmentPost Zinforo treatment, during index hospitalization, index hospitalization was maximum of 102 days for CAP; maximum of 162 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)

Clinical response in CAP:participants demonstrating clinical stability(i.e.,according to IDSA guidelines:temperature of\<=37.8 degree Celsius,heart rate of \<=100 beats per minute,respiratory rate of \<=24 breaths per minute,systolic blood pressure of \>=90 mmHg,oxygen saturation of \>=90%,confusion/disorientation recorded as absent),clinical improvement(i.e.,improvement of at least 1 of 4 symptoms present at Baseline(i.e.,cough,dyspnea,pleuritic chest pain,sputum production)with worsening of none).Clinical response in cSSTI participants:\>=20% reduction from baseline infection area,cessation of spread measured by total infection area.Clinical failure for both CAP and cSSTI:any of the following:treatment modification due to AE;drug-drug interaction;insufficient response(followed by switch);death due to index infection;death due to other cause;relapse or recurrence. Number of participants classified according to treatment responses to post-Zinforo treatment reported in this outcome measure.

Number of Participant According to Type of Location for Post-Zinforo Treatment AdministrationPost Zinforo treatment, during index hospitalization, index hospitalization was maximum of 102 days for CAP; maximum of 162 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)

The number of participants were classified according to the locations in which post-Zinforo treatment was administered. One participant could have more than one location of administration.

Duration in Intensive Care UnitDuring index hospitalization, index hospitalization was maximum of 102 days for CAP; maximum of 162 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)
Number of Participants According to Reasons for Re-hozpitalizationDay 1 of re-hospitalization till discharge (from the retrospective data evaluated in approximately 14 months of the study)

The number of participants were classified according to reasons for re-hospitalizations were reported in this outcome measure. Re-hospitalization (if any) that happened within 30 days post discharge from index hospitalization.

Number of Participants Requiring IsolationDuring index hospitalization, index hospitalization was maximum of 102 days for CAP; maximum of 162 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)

The number of participants who required isolation were reported in this outcome measure.

Cost of HospitalizationDay 1 of index hospitalization till discharge, index hospitalization was maximum of 102 days for CAP; maximum of 162 days for cSSTI (from the retrospective data evaluated in approximately 14 months of the study)

The cost of hospitalization of standard level hospitals was calculated as total hospital cost= total number of bed days \* per diem rate standard hospital general ward and the cost of hospitalization of advanced level hospitals was calculated as total number of bed days \* per diem rate advanced hospital.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (26)

Hospital Universitario Valle de Hebrón

🇪🇸

Barcelona, Spain

Hospital Ramon y Cajal

🇪🇸

Madrid, Spain

Centro médico Imbanaco

🇨🇴

Cali, Colombia

Asst Spedali Civili Brescia and Universita Degli Studi di Brescia

🇮🇹

Brescia, Other, Italy

AORN Ospedali dei Colli - Ospedale Monaldi

🇮🇹

Napoli, Other, Italy

BUZ UR First Republican Clinical Hospital under the Ministry of Healthcare of Udmurt Republic UR

🇷🇺

Izhevsk, Udmurtia, Russian Federation

Fundación Valle del Lili

🇨🇴

Cali, Valle DEL Cauca, Colombia

Hospital Clínic

🇪🇸

Barcelona, Spain

Real Hospital Português de Beneficência

🇧🇷

Recife, PE, Brazil

Hospital Esperança

🇧🇷

Recife, Brazil

Clínica Las Américas

🇨🇴

Medellin, Antioquia, Colombia

CHU de Grenoble Alpes

🇫🇷

Grenoble, France

CHU Nantes

🇫🇷

Nantes, France

Attikon University General Hospital

🇬🇷

Athens, Greece

University Hospital of Heraklion

🇬🇷

Heraklion, Greece

Patras University Medical School

🇬🇷

Patras, Greece

AHEPA General University Hospital of Thessaloniki

🇬🇷

Thessaloniki, Greece

Hospital Universitario 12 de Octubre

🇪🇸

Madrid, Spain

Croix-Rousse hospital, Hospices Civils de Lyon

🇫🇷

Lyon, France

CHU Francois Mitterrand

🇫🇷

Dijon, France

General University Hospital of Larissa

🇬🇷

Larissa, Greece

Azienda Ospedaliera Dei Colli

🇮🇹

Napoli, Italy

Aou Citta Della Salute E Della Scienza Scdu Malattie Infettive 2

🇮🇹

Turin, Italy

Azienda Sanitaria Universitaria Friuli Centrale (ASU FC), Presidio Ospedaliero Universitario Santa

🇮🇹

Udine, Italy

Republican Clinical Hospital named after G.G. Kuvatova

🇷🇺

Ufa, Republic OF Bashkortostan, Russian Federation

E.S.E. Hospital Universitario San Jorge de Pereira

🇨🇴

Pereira, Risaralda, Colombia

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