Ceftazidime-avibactam for the treatment of complicated intra-abdominal infections

ABSTRACT

Introduction: The treatment of complicated intra-abdominal infections (cIAI) is increasingly challenging due to increased resistance of Gram-negative organisms. These multidrug resistant organisms lead to an increase in morbidity and mortality. This has led to renewed interest in use of older β-lactam antibiotics in combination with newer β-lactamase inhibitors. Ceftazidime-avibactam is one of the newest such combination antibiotics, which has been released for treatment of complicated intra-abdominal infections in combination with metronidazole.

Areas covered: In this drug evaluation manuscript cIAI along with the chemistry, pharmacodynamics, pharmacokinetics, metabolism and clinical study results of ceftazidime-avibactam are reviewed.

Expert opinion: The role of ceftazidime-avibactam in combination with metronidazole in the treatment of cIAI is still to be defined. Patients with cIAI known to be infected with Klebsiella pneumoniae carbapenemase-producing Enterobacteriaceae would be clear candidates for treatment with this agent, as would patients infected with more common types of extended-spectrum β-lactamase producing Gram-negative pathogens if a carbapenem alternative were desired. At present, it is difficult to establish a clear group of patients with cIAI for whom initial empiric therapy with this agent would be warranted.

KEYWORDS:

• Antibiotic resistance
• ceftazidime-avibactam
• complicatedintra-abdominal infections
• β-lactam-β-lactamase inhibitors

Declaration of interest

AE Muller has directly or indirectly consulted for Polyphor, Basilea. AstraZeneca, Nordic Pharma and Wockhardt. JE Mazuski has received research support from AstraZeneca, Bayer, and Merck, and has received honoraria for service as a consultant, advisory board member, or speaker for Allergan, Bayer, and Merck. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

This paper is not funded.