In vitro activity of Ceftazidime–Avibactam and its comparators against Carbapenem resistant Enterobacterales collected across India: results from ATLAS surveillance 2018 to 2019

Bakthavatchalam, Yamuna Devi; Routray, Abhisek; Mane, Akshata; Kamat, Shweta; Gupta, Anu; Bari, Anurag Kumar; Rohit, Anusha; Poojary, Aruna; Mukherjee, Dip Narayan; Sethuraman, Nandini; Munshi, Nita; Shah, Sweta; Veeraraghavan, Balaji; Gupta, Yogesh

doi:10.1016/j.diagmicrobio.2022.115652

Cited by 23 publications

(27 citation statements)

References 31 publications

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“…An overall susceptibility rate of over 70% was reported among K. pneumoniae and E. coli isolates. Around 51% of carbapenem-resistant (CR)- K. pneumoniae and 24% of CR- E. coli isolates were found to be susceptible to ceftazidime-avibactam [ 5 ].…”

Section: Reviewmentioning

confidence: 99%

“…Tigecycline and colistin face challenges such as low plasma concentration and nephrotoxicity, respectively [ 5 , 65 , 66 ]. Colistin may be limited in its use due to its narrow therapeutic index, challenges with dose optimization, poor lung penetration, nephrotoxicity, and emerging antimicrobial resistance [ 61 , 65 , 67 ].…”

Section: Reviewmentioning

confidence: 99%

“…The carbapenem resistance in Enterobacterales is driven by carbapenemases such as New Delhi metallo-β-lactamase (NDM), and Oxacillinase-48 like (OXA-48-like) VIM, IMP and KPC [ 3 , 4 ]. In India, high carbapenem resistance among Enterobacterales has been reported by the Indian Council of Medical Research (ICMR) with resistance rates up to 30% for Escherichia coli and 50% for Klebsiella pneumoniae [ 5 ]. OXA-48-like gene was identified in 52% of the carbapenem-resistant (CR)- K. pneumoniae isolates while 20% isolates possessed NDM gene and 27% isolates had both NDM with OXA-48-like gene.…”

Section: Introductionmentioning

confidence: 99%

“…OXA-48-like gene was identified in 52% of the carbapenem-resistant (CR)- K. pneumoniae isolates while 20% isolates possessed NDM gene and 27% isolates had both NDM with OXA-48-like gene. However, in carbapenem-resistant (CR)- E. coli , NDM was identified in 68% of isolates followed by OXA-48-like in 24% isolates and 8% isolates carried both NDM with OXA-48-like gene [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…Colistin and tigecycline have been used as first-line therapy for managing infections caused by CREs [ 8 ]. However, tigecycline does not attain the required plasma concentrations, and hence may not be used for treating bloodstream infections [ 5 ]. Colistin has been associated with prominent toxicity (both nephrotoxicity and neurotoxicity), which may limit its clinical use [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

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Early and Appropriate Use of Ceftazidime-Avibactam in the Management of Multidrug-Resistant Gram-Negative Bacterial Infections in the Indian Scenario

Swaminathan¹,

Routray²,

Mane³

2022

Cureus

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The increasing prevalence of antibiotic-resistant pathogens exerts a substantial burden on the healthcare infrastructure worldwide. The World Health Organization (WHO) has declared that multidrug-resistant (MDR) Gram-negative pathogens, especially, carbapenem-resistant Enterobacterales (CRE), Acinetobacter baumannii, and Pseudomonas aeruginosa as the topmost priority while developing newer antimicrobials. The increasing prevalence of infectious diseases caused by MDR Gram-negative bacteria also poses a challenge when choosing the empiric antimicrobial therapy for seriously ill hospitalized patients. The infections caused by MDR Gram-negative organisms ultimately result in increased mortality, morbidity, prolonged hospital stay, and increased cost of management. To tackle these challenges, newer antimicrobials like ceftazidime-avibactam were explored. The article also discusses the in vitro activity and therapeutic efficacy of ceftazidime-avibactam along with its pharmacokinetic properties and the role it will play in the management of MDR Gram-negative organisms in the Indian setting. Several studies have highlighted the role of early and appropriate antibiotic use in the reduction of mortality in patients with Gram-negative infections. Timely initiation of appropriate antibiotic therapy for serious infections leads to favorable clinical outcomes. Early and appropriate use of ceftazidime-avibactam while treating MDR Gram-negative infections has been associated with improved clinical outcomes. The aim of this review is to highlight the efficacy of ceftazidime-avibactam in the treatment of MDR Gram-negative infections. We have also summarized the information on outcomes achieved by early and appropriate use of ceftazidime-avibactam.

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Section: Reviewmentioning

confidence: 99%