CACTUS Trial Journal Club
We break down evidence-based medicine so you don't have to! This journal club will discuss the new CACTUS trial that is hot in the medical literature right now.
The Lancet Infectious Diseases published the CACTUS trial online ahead of print in December 2024. The printed article was included in the May 2025 printed edition. This post is a journal club breaking down the CACTUS trial and what change it may bring to our clinical practice.
Background/Overview
Title: Effectiveness of ceftazidime–avibactam versus ceftolozane– tazobactam for multidrug-resistant Pseudomonas aeruginosa infections in the USA (CACTUS): a multicentre, retrospective, observational study
Citation: Shields RK, Abo LM, Ackley R, et al. Effectiveness of ceftazidime–avibactam versus ceftolozane–tazobactam for multidrug-resistant Pseudomonas aeruginosa infections in the USA (CACTUS): a multicentre, retrospective, observational study. Lancet Infect Dis May 2025;25:574-84. Published online December 2024.
Objective: to compare the effectiveness of ceftolozane–tazobactam and ceftazidime–avibactam for treatment of invasive multidrug-resistant (MDR) P aeruginosa infections
Hypothesis: treatment with ceftolozane–tazobactam leads to higher rates of clinical success compared with treatment with ceftazidime–avibactam for patients with MDR P aeruginosa infections
Primary Efficacy Measure: Clinical success at day 30 from treatment initiation, defined as:
- Survival
- Resolution of symptoms
- No drug change due to failure
- No recurrent P. aeruginosa infection