Ceftazidime/avibactam, Meropenem/vaborbactam or both? Clinical and formulary considerations.

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Ceftazidime/avibactam, Meropenem/vaborbactam or both? Clinical and formulary considerations.

Clin Infect Dis. 2018 Jul 18;:

Authors: Pogue JM, Bonomo RA, Kaye KS

Abstract
Ceftazidime/avibactam and Meropenem/vaborbactam are changingthe management of invasive infections due to carbapenem-resistant enterobacteriaceae (CRE) leading to higher rates of clinical cure, decreased mortality, and decreased rates of acute kidney injury when compared to colistin-based regimens. However, these two agents are not interchangeable with regards to management of CRE infections, and clinicians need to be aware of their differences. This review focuses on differences in in vitro activity of these agents as a function of mechanism of carbapenem resistance, the clinical data supporting their superiority over colistin-based therapy, and the differences between agents with regards to propensity for selection of resistance. Furthermore, considerations and recommendations for hospital formularies and antibiotic stewardship programs regarding positioning of these agents are discussed.

PMID: 30020449 [PubMed - as supplied by publisher]