Tackling carbapenem resistance: ceftazidime - avibactam in contemporary clinical scenarios

Authors

  • Manish Maladkar Scientific Department, Aristo Pharmaceuticals Private Ltd., Mumbai, Maharashtra, India
  • Shrikant Patil Scientific Department, Aristo Pharmaceuticals Private Ltd., Mumbai, Maharashtra, India
  • Namita Anchan Scientific Department, Aristo Pharmaceuticals Private Ltd., Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20241026

Keywords:

Ceftazidime-Avibactam, Antibiotic resistance, Gram-negative bacteria, Carbapenemases, Carbapenem-resistant, Carbapenem-resistant Enterobacteriaceae, OXA-48

Abstract

Antimicrobial resistance poses a formidable challenge in treating severe infections, with the prevalence of extended-spectrum beta-lactamase (ESBL) - producing, Klebsiella pneumoniae carbapenemase (KPC) - producing, and multidrug-resistant (MDR) organisms on the rise. This necessitates careful consideration of various factors, including local resistance patterns, patient-specific characteristics, and drug properties, in treatment decisions for critically ill patients. Ceftazidime-Avibactam demonstrates efficacy against aerobic Gram-negative bacteria and offers a crucial advancement against carbapenem-resistant organisms (CRO) with its effectiveness against key pathogens, including ESBL, AmpC, KPC, and OXA-48-producing Enterobacteriaceae and drug-resistant P. aeruginosa. Ceftazidime-Avibactam emerges as a valuable option for critically ill patients with limited treatment choices. The drug's excellent safety profile demonstrated in clinical trials, further positions it as a crucial addition to antimicrobial treatment options. As the global threat of drug-resistant bacteria grows, Ceftazidime-Avibactam plays a pivotal role in addressing this challenge and offers a promising solution for critically ill patients facing infections caused by antimicrobial-resistant pathogens. The article delves into therapeutic efficacy and the prospective role of Ceftazidime-Avibactam in managing MDR Gram-negative organisms, underscoring the critical role of appropriate antibiotic administration in reducing mortality associated with Gram-negative infections.

References

Muteeb G, Rehman MT, Shahwan M, Aatif M. Origin of Antibiotics and Antibiotic Resistance, and Their Impacts on Drug Development: A Narrative Review. Pharmaceuticals (Basel). 2023;16(11):1615.

Ahmed S, Ahmed MZ, Rafique S, Almasoudi SE, Shah M, Jalil NAC, et al. Recent Approaches for Downplaying Antibiotic Resistance: Molecular Mechanisms. Biomed Res Int. 2023;2023:5250040.

Tang KWK, Millar BC, Moore JE. Antimicrobial Resistance (AMR). Br J Biomed Sci. 2023;80:11387.

Antimicrobial Resistance Collaborators. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. Lancet. 2022;400(10358):1102.

Breijyeh Z, Jubeh B, Karaman R. Resistance of Gram-Negative Bacteria to Current Antibacterial Agents and Approaches to Resolve It. Molecules. 2020;25(6):1340.

Nagvekar V, Sawant S, Amey S. Prevalence of multidrug-resistant Gram-negative bacteria cases at admission in a multispeciality hospital. J Glob Antimicrob Resist. 2020;22:457-61.

Sharma R, Park TE, Moy S. Ceftazidime-Avibactam: A Novel Cephalosporin/β-Lactamase Inhibitor Combination for the Treatment of Resistant Gram-negative Organisms. Clin Ther. 2016;38(3):431-44.

Das S. The crisis of carbapenemase-mediated carbapenem resistance across the human-animal-environmental interface in India. Infect Dis Now. 2023;53(1):104628.

Swaminathan S, Routray A, Mane A. Early and Appropriate Use of Ceftazidime-Avibactam in the Management of Multidrug-Resistant Gram-Negative Bacterial Infections in the Indian Scenario. Cureus. 2022;14(8):e28283.

Hobson CA, Pierrat G, Tenaillon O, Bonacorsi S, Bercot B, Jaouen E, et al. Klebsiella pneumoniae Carbapenemase Variants Resistant to Ceftazidime-Avibactam: an Evolutionary Overview. Antimicrob Agents Chemother. 2022;66(9):e0044722.

Fiore M, Alfieri A, Di Franco S, Pace MC, Simeon V, Ingoglia G, et al. Ceftazidime-Avibactam Combination Therapy Compared to Ceftazidime-Avibactam Monotherapy for the Treatment of Severe Infections Due to Carbapenem-Resistant Pathogens: A Systematic Review and Network Meta-Analysis. Antibiotics (Basel). 2020;9(7):388.

Soriano A, Carmeli Y, Omrani AS, Moore LSP, Tawadrous M, Irani P. Ceftazidime-Avibactam for the Treatment of Serious Gram-Negative Infections with Limited Treatment Options: A Systematic Literature Review. Infect Dis Ther. 2021;10(4):1989-2034.

Tuon FF, Rocha JL, Formigoni-Pinto MR. Pharmacological aspects and spectrum of action of ceftazidime-avibactam: a systematic review. Infection. 2018;46(2):165-81.

Liscio JL, Mahoney MV, Hirsch EB. Ceftolozane/tazobactam and ceftazidime/avibactam: two novel β-lactam/β-lactamase inhibitor combination agents for the treatment of resistant Gram-negative bacterial infections. Int J Antimicrob Agents. 2015;46(3):266-71.

Xu T, Guo Y, Ji Y, Wang B, Zhou K. Epidemiology and Mechanisms of Ceftazidime–Avibactam Resistance in Gram-Negative Bacteria. Engineering. 2022;11:138-45.

Barber KE, Ortwine JK, Akins RL. Ceftazidime/Avibactam: Who Says You Can't Teach an Old Drug New Tricks? J Pharm Pharm Sci. 2016;19(4):448-64.

Zasowski EJ, Rybak JM, Rybak MJ. The β-Lactams Strike Back: Ceftazidime-Avibactam. Pharmacotherapy. 2015;35(8):755-70.

Zhanel GG, Lawson CD, Adam H, Schweizer F, Zelenitsky S, Lagacé-Wiens PR, et al. Ceftazidime-avibactam: a novel cephalosporin/β-lactamase inhibitor combination. Drugs. 2013;73(2):159-77.

De Sousa Coelho F, Mainardi JL. The multiple benefits of second-generation β-lactamase inhibitors in treatment of multidrug-resistant bacteria. Infect Dis Now. 2021;51(6):510-7.

Sreenivasan P, Sharma B, Kaur S, Rana S, Biswal M, Ray P, et al. In-vitro susceptibility testing methods for the combination of ceftazidime-avibactam with aztreonam in metallobeta-lactamase producing organisms: Role of combination drugs in antibiotic resistance era. J Antibiot (Tokyo). 2022;75(8):454-62.

Wagenlehner FM, Sobel JD, Newell P, Armstrong J, Huang X, Stone GG, et al. Ceftazidime-avibactam Versus Doripenem for the Treatment of Complicated Urinary Tract Infections, Including Acute Pyelonephritis: RECAPTURE, a Phase 3 Randomized Trial Program. Clin Infect Dis. 2016;63(6):754-62.

Carmeli Y, Armstrong J, Laud PJ, Newell P, Stone G, Wardman A, et al. Ceftazidime-avibactam or best available therapy in patients with ceftazidime-resistant Enterobacteriaceae and Pseudomonas aeruginosa complicated urinary tract infections or complicated intra-abdominal infections (REPRISE): a randomised, pathogen-directed, phase 3 study. Lancet Infect Dis. 2016;16(6):661-73.

Torres A, Rank D, Melnick D, Rekeda L, Chen X, Riccobene T, et al. Randomized Trial of Ceftazidime-Avibactam vs Meropenem for Treatment of Hospital-Acquired and Ventilator-Associated Bacterial Pneumonia (REPROVE): Analyses per US FDA-Specified End Points. Open Forum Infect Dis. 2019;6(4):ofz149.

Nagvekar V, Shah A, Unadkat VP, Chavan A, Kohli R, Hodgar S, et al. Clinical Outcome of Patients on Ceftazidime-Avibactam and Combination Therapy in Carbapenem-resistant Enterobacteriaceae. Indian J Crit Care Med. 2021;25(7):780-4.

Jorgensen SCJ, Trinh TD, Zasowski EJ, Lagnf AM, Bhatia S, Melvin SM, et al. Real-World Experience With Ceftazidime-Avibactam for Multidrug-Resistant Gram-Negative Bacterial Infections. Open Forum Infect Dis. 2019;6(12):ofz522.

Vena A, Giacobbe DR, Castaldo N, Cattelan A, Mussini C, Luzzati R, et al. Clinical experience with ceftazidime-avibactam for the treatment of infections due to multidrug-resistant gram-negative bacteria other than carbapenem-resistant Enterobacterales. Antibiotics. 2020;9(2):1-15.

Santevecchi BA, Smith TT, MacVane SH. Clinical experience with ceftazidime/avibactam for treatment of antibiotic-resistant organisms other than Klebsiella pneumoniae. Int J Antimicrob Agents. 2018;51(4):629-35.

Shields RK, Nguyen MH, Chen L, Press EG, Potoski BA, Marini RV, et al. Ceftazidime-Avibactam Is Superior to Other Treatment Regimens against. Antimicrob Agents Chemother. 2017;61(8):1-7.

Chen J, Hu Q, Zhou P, Deng S. Ceftazidime–avibactam versus polymyxins in treating patients with carbapenem-resistant Enterobacteriaceae infections: a systematic review and meta-analysis. Infection. 2023;0123456789.

Van Duin D, Lok JJ, Earley M, Cober E, Richter SS, Perez F, et al. Colistin Versus Ceftazidime-Avibactam in the Treatment of Infections Due to Carbapenem-Resistant Enterobacteriaceae. Clin Infect Dis. 2018;66(2):163-71.

Almangour TA, Ghonem L, Aljabri A, Alruwaili A, Al Musawa M, Damfu N, et al. Ceftazidime-Avibactam versus Colistin for the Treatment of Infections Due to Carbapenem-Resistant Enterobacterales: A Multicenter Cohort Study. Infect Drug Resist. 2022;15:211-21.

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Published

2024-04-26

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Section

Review Articles