Update on the Role of Ceftazidime-Avibactam in the Management of Carbapenemase-Producing Enterobacterales

Abstract

Ceftazidime-avibactam is a novel combination of a known cephalosporin and a non-β-lactam/β-lactamase inhibitor that has been approved for the treatment of complicated intra-abdominal and urinary tract infections, hospital-acquired pneumonia as well as Gram-negative infections with limited treatment options in Europe. Since its approval, it has been used in patients with infections due to carbapenem-resistant bacteria, in many occasions as off-label indication or salvage therapy, with promising clinical and microbiological cure rates. Emergence of resistance during therapy to this new combination has already been described, which is a matter of concern. A rational use of these new therapeutic options is critical in the multidrug resistance era. The current review focuses on the clinical experience in real life of ceftazidime-avibactam use in the treatment of carbapenemase-producing Enterobacterales.

Keywords::

• antibacterial agents
• avibactam
• β-lactamase inhibitors
• carbapenem-resistant Enterobacteriaceae
• ceftazidime drug combination
• drug-resistant bacterial infections
• Enterobacteriaceae
• Gram-negative bacteria
• multidrug resistance

Author contributions

B Dietl and LM Martínez have conducted the bibliographic search. B Dietl has written the clinical points in the article and LM Martínez has focused on the pharmacological aspects. E Calbo and J Garau have reviewed and corrected the manuscript.

Financial & competing interests disclosure

B Dietl receives grants from MSD, Pfizer and Viiv Healthcare. 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.

No writing assistance was utilized in the production of this manuscript.

Additional information

Funding

B Dietl receives grants from MSD, Pfizer and Viiv Healthcare. 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.