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Clin Infect Dis. 2016 Jul 15;63(2):234-41. doi: 10.1093/cid/ciw243. Epub 2016 Apr 20.

Ceftazidime/Avibactam and Ceftolozane/Tazobactam: Second-generation β-Lactam/β-Lactamase Inhibitor Combinations.

Author information

1
Division of Infectious Diseases, University of North Carolina, Chapel Hill.
2
Research Service, Louis Stokes Cleveland Department of Veterans Affairs Medical Center Division of Infectious Diseases and HIV Medicine, Department of Medicine Department of Molecular Biology and Microbiology Department of Pharmacology, Case Western Reserve University School of Medicine, Cleveland, Ohio.

Abstract

Ceftolozane/tazobactam and ceftazidime/avibactam are 2 novel β-lactam/β-lactamase combination antibiotics. The antimicrobial spectrum of activity of these antibiotics includes multidrug-resistant (MDR) gram-negative bacteria (GNB), including Pseudomonas aeruginosa. Ceftazidime/avibactam is also active against carbapenem-resistant Enterobacteriaceae that produce Klebsiella pneumoniae carbapenemases. However, avibactam does not inactivate metallo-β-lactamases such as New Delhi metallo-β-lactamases. Both ceftolozane/tazobactam and ceftazidime/avibactam are only available as intravenous formulations and are dosed 3 times daily in patients with normal renal function. Clinical trials showed noninferiority to comparators of both agents when used in the treatment of complicated urinary tract infections and complicated intra-abdominal infections (when used with metronidazole). Results from pneumonia studies have not yet been reported. In summary, ceftolozane/tazobactam and ceftazidime/avibactam are 2 new second-generation cephalosporin/β-lactamase inhibitor combinations. After appropriate trials are conducted, they may prove useful in the treatment of MDR GNB infections. Antimicrobial stewardship will be essential to preserve the activity of these agents.

KEYWORDS:

Enterobacteriaceae; Pseudomonas; ceftazidime/avibactam; ceftolozane/tazobactam; multidrug resistance

PMID:
27098166
PMCID:
PMC4928383
DOI:
10.1093/cid/ciw243
[Indexed for MEDLINE]
Free PMC Article

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