By Ethan Covey
Ceftazidime-avibactam (C/A; Avycaz, Allergan) may be a viable, effective treatment alternative to ceftolozane-tazobactam (C/T; Zerbaxa, Merck) for patients with Pseudomonas aeruginosa infections, according to a study presented at the 2022 IDWeek conference, held in Washington, D.C.
“Novel beta-lactam/beta-lactamase inhibitors including C/T and C/A are first-line treatments for resistant Pseudomonas aeruginosa infections,” said Austin Golia, PharmD, an infectious diseases clinical pharmacist at Nassau University Medical Center, in East Meadow, N.Y. “C/T may often be preferred due to narrower spectrum and lower cost for P. aeruginosa.”
From December 2020 through January 2022, there was a global shortage of C/T, which resulted in the adoption of C/A as an alternative for treatment of P. aeruginosa infections in many healthcare settings. Yet, data regarding the use of C/A for P. aeruginosa are limited, and no direct evidence comparing the use of C/A and C/T in this area existed, according to the researchers.
Dr. Golia and his team conducted the study to evaluate the real-world experience of using C/A in place of C/T to treat these infections among adults admitted to Montefiore Medical Center between Jan. 1, 2018, and Dec. 31, 2021 (poster 1729). All patients included in the analysis received C/A or C/T for more than 48 hours for a culture-proven P. aeruginosa infection. A total of 46 patients were included in the C/A group, and 56 patients were placed in the C/T group.
The researchers found the clinical success between both the C/A and C/T arms to be similar (72% and 63%, respectively). Dr. Golia noted the importance of close monitoring for the development of drug resistance, as resistance at 90 days occurred more regularly in the C/A group, at rates that approached statistical significance.
Dr. Golia also said future comparative studies, which ideally would be performed on more homogeneous patient groups, are necessary to validate this study’s findings.
