Antimicrob Agents Chemother. 2021 Apr 19:AAC.02318-20. doi: 10.1128/AAC.02318-20. Online ahead of print.
Ceftolozane-tazobactam (C/T) is a new fifth-generation cephalosporin/β-lactamase inhibitor combination approved by the Food and Drug Administration and the European Medicines Agency for treatment of complicated intra-abdominal infections, complicated urinary tract infections, and hospital-acquired pneumonia in adult patients. This review will briefly describe the pharmacology of C/T and focus on the emerging clinical trial and real-world data supporting its current utilization. Additionally, our synthesis of this data over time has set our current usage of C/T at Barnes-Jewish Hospital (BJH). C/T is primarily employed as directed monotherapy at BJH when P. aeruginosa isolates are identified with resistance to other beta-lactams. C/T can also be used empirically at BJH prior to microbiologic detection of an antibiotic-resistant P. aeruginosa isolate in specific clinical situations. These situations include critically ill patients in the ICU setting where there is a high likelihood of infection with multidrug-resistant (MDR) P. aeruginosa including patients failing therapy with a carbapenem, specific patient populations known to be at high risk for infection with MDR P. aeruginosa (e.g., lung transplant and cystic fibrosis patients), and patients know to have previous infection or colonization with MDR P. aeruginosa.