Ceftazidime-Avibactam Treatments for Carbapenem-Resistant Infections
Summary
Ceftazidime-avibactam combines a third-generation cephalosporin with a novel non-β-lactam β-lactamase inhibitor to target carbapenem-resistant Gram-negative pathogens. Avibactam restores ceftazidime activity against organisms producing class A carbapenemases (notably KPC), class C cephalosporinases and certain class D oxacillinases, while retaining favourable pharmacokinetics for severe infections. Its introduction has transformed management of infections due to carbapenem-resistant Enterobacterales, Pseudomonas aeruginosa and other difficult-to-treat non-fermenters, offering improved clinical success and reduced nephrotoxicity compared with polymyxin-based regimens. Clinical use spans complicated urinary and intra-abdominal infections, hospital-acquired pneumonia including ventilator-associated pneumonia, bacteraemia and deep-seated infections. Emerging data support monotherapy for susceptible strains, extended-infusion dosing in critically ill patients to maximise pharmacodynamic exposure and early administration to improve outcomes. Nevertheless, vigilance for treatment-emergent resistance, optimisation of combination strategies and tailored dosing in special populations—such as renal impairment, extracorporeal support or high-inoculum infections—remain crucial research priorities. Global surveillance and stewardship are essential to preserve efficacy and guide empirical therapy in regions with diverse carbapenemase epidemiology.
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Ceftazidime-Avibactam Treatments for Carbapenem-Resistant Infections publication trend
The graph below shows the total number of articles in ceftazidime-avibactam treatments for carbapenem-resistant infections across all publications each year (not limited to Nature Index journals).
Technical terms
Carbapenemase: An enzyme produced by certain bacteria that hydrolyses carbapenem antibiotics, conferring resistance to this class.
β-Lactamase inhibitor: A compound that binds to and inactivates β-lactamase enzymes, restoring the activity of β-lactam antibiotics against resistant bacteria.
Minimal inhibitory concentration (MIC): The lowest concentration of an antibiotic that prevents visible growth of a microorganism in vitro, used to gauge susceptibility.
APACHE II score: A severity-of-disease classification system (Acute Physiology and Chronic Health Evaluation II) used to predict mortality risk in critically ill patients.
References
- Rationale and evidence for the use of new beta-lactam/beta-lactamase inhibitor combinations and cefiderocol in critically ill patients. Annals of Intensive Care (2023).
- Clinical outcomes and risk factors for mortality in recipients with carbapenem-resistant gram-negative bacilli infections after kidney transplantation treated with ceftazidime-avibactam: a retrospective study. Frontiers in Cellular and Infection Microbiology (2024).
- Efficacy and Safety of Ceftazidime–Avibactam Alone versus Ceftazidime–Avibactam Plus Fosfomycin for the Treatment of Hospital-Acquired Pneumonia and Ventilator-Associated Pneumonia: A Multicentric Retrospective Study from the SUSANA Cohort. Antibiotics (2024).
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