Experience of Ceftazidime/avibactam in a UK tertiary cardiopulmonary specialist center.
Expert Rev Anti Infect Ther. 2020 Aug 15;:
Authors: Nwankwo L, Butt Z, Schelenz S
OBJECTIVES: Antimicrobial resistance is a major threat to public health. New drugs such as Ceftazidime/avibactam have been developed for the treatment of Multi-Drug resistant (MDR) pathogens. Susceptibility can be variable and inappropriate use can add a financial strain on the National Health Service (NHS). There is a pressing need to ensure these new and invaluable antimicrobials are preserved and used effectively.
METHODS: We undertook a retrospective observational study to assess the use of Ceftazidime/avibactam and evaluated prescribing against applied standards.
RESULTS: Between August 2017 and January 2019, 28 patients received 31 courses of Ceftazidime/avibactam. Prescribing according to the approved indications was observed for 68% of prescriptions (p<0.0001). Duration of therapy was often prolonged but improved with Antimicrobial stewardship interventions. We observed 56% susceptibility (15/27 isolates) of MDR organisms (Pseudomonas, Klebsiella, Burkholderia, Enterobacter aerogenes, Achromobacter). We also report first in vivo experience to treat pulmonary disease caused by Non-tuberculous mycobacteria (NTM). Ceftazidime/avibactam was well tolerated, with no evidence of development of resistance at six months follow-up.
CONCLUSIONS: Our study showed that Antimicrobial stewardship interventions led to a more appropriate use of Ceftazidime/avibactam (as measured by duration of therapy), preserving it as a treatment option for MDR infections.
PMID: 32799594 [PubMed - as supplied by publisher]