Clinical experience with ceftazidime/avibactam for treatment of antibiotic-resistant organisms other than Klebsiella pneumoniae

Clinical Experience with Ceftazidime-Avibactam for the Treatment of Infections due to Multidrug-Resistant Gram-Negative Bacteria Other than Carbapenem-Resistant Enterobacterales

“…Consistent with previous reports [17,32], we were unable to detect adverse drug events related to ceftazidime-avibactam treatment, even when the drug was administered for a relatively prolonged period of time (median of 13 days (range 2-49 days)). However, due to the retrospective nature of our data we are limited to that information reported in the medical records.…”

“…Although real-life experiences of ceftazidime-avibactam for the treatment of CRE is accumulating [9][10][11][12][13][14][15], data regarding its effectiveness and safety for the treatment of other gram-negative infections remain rare [16][17][18] and, to the best of our knowledge, are limited to only three single-center retrospective studies including a total of 20 patients. In the largest of these analyses, Santevecchi et al [17] reported a clinical success rate of 70% in ten multidrug resistant gram-negative infections treated with ceftazidime-avibactam. In our study, we report an overall clinical success rate of 90%.…”

“…One of the most concerning issue related to ceftazidime-avibactam therapy is the rate of recurrence and the appearance of ceftazidime-avibactam resistance during or after treatment [12]. In their study, Santavecchi et al [17] described the emergence of resistance while on therapy with ceftazidime-avibactam in 2 out of 10 patients (20%) who were treated for 50 and 13 days, respectively. In our study, although with the limitations of the non-standardized collection of follow-up samples, no resistance to ceftazidime-avibactam was detected.…”

“…Ceftazidime-avibactam is a new β-lactam/β-lactamase inhibitor currently approved by the European Medicines Agency for the treatment of complicated intra-abdominal infections [5,6], complicated urinary tract infections [7], hospital-acquired pneumonia (including ventilator-associated pneumonia), and more generally, for aerobic gram-negative infections with limited treatment options [8]. In real-life experiences, high rates of favorable response to ceftazidime-avibactam treatment are reported in patients with infections due to carbapenem−resistant Enterobacterales (CRE), with an overall success rate of about 70% [9][10][11][12][13][14][15], whereas post-marketing experience regarding the use of ceftazidime-avibactam for infections due to MDR-GNB other than CRE remains scarce [16][17][18] Moreover, information regarding features associated with clinical failures and the emergence of resistance in this group of patients are even scarcer. For this reason, in this multicenter study we describe our experience about the use of ceftazidime-avibactam for the treatment of infections due to MDR-GNB other than CRE in 13 Italian hospitals.…”

Approach to the Treatment of Patients with Serious Multidrug‐Resistant Pseudomonas aeruginosa Infections

“…Two newer cephalosporin-b-lactamase inhibitor combinations, CZA and C-T, are increasingly used in the treatment of patients with MDR-PSA infections. [62][63][64][65][66][67][68][69][70][71] Ceftazidime is a third-generation antipseudomonal cephalosporin with a wellestablished efficacy and safety profile, and avibactam is a diazabicyclooctane b-lactamase inhibitor. Avibactam has no intrinsic activity alone, but expands the spectrum of activity of ceftazidime certain PSA strains by inhibiting a broad range of serine b-lactamases, including Ambler class A (extended spectrum b-lactamase and Klebsiella pneumoniae carbapenemase), class C (AmpC), and some class D (such as OXA-48) enzymes.…”