title: Ceftazidime-avibactam for the treatment of complicated intra-abdominal infections.
abstract: The treatment of complicated intra-abdominal infections (cIAI) is increasingly challenging due to increased resistance of Gram-negative organisms. These multidrug resistant organisms lead to an increase in morbidity and mortality. This has led to renewed interest in use of older β-lactam antibiotics in combination with newer β-lactamase inhibitors. Ceftazidime-avibactam is one of the newest such combination antibiotics, which has been released for treatment of complicated intra-abdominal infections in combination with metronidazole. Areas covered: In this drug evaluation manuscript cIAI along with the chemistry, pharmacodynamics, pharmacokinetics, metabolism and clinical study results of ceftazidime-avibactam are reviewed. Expert opinion: The role of ceftazidime-avibactam in combination with metronidazole in the treatment of cIAI is still to be defined. Patients with cIAI known to be infected with Klebsiella pneumoniae carbapenemase-producing Enterobacteriaceae would be clear candidates for treatment with this agent, as would patients infected with more common types of extended-spectrum β-lactamase producing Gram-negative pathogens if a carbapenem alternative were desired. At present, it is difficult to establish a clear group of patients with cIAI for whom initial empiric therapy with this agent would be warranted.
authors.affiliation: a Department of Acute and Critical Care Surgery , Washington University School of Medicine , Saint Louis , USA.
authors.forename: Sara A
authors.initials: SA
authors.lastname: Buckman
authors.affiliation: b Department of Pharmacy, Infectious Diseases Clinical Pharmacy Specialist , Barnes-Jewish Hospital , Saint Louis , USA.
authors.forename: Tamara
authors.initials: T
authors.lastname: Krekel
authors.affiliation: c Department of Medical Microbiology , Medical Centre Haaglanden-Bronovo , The Hague , The Netherlands.
authors.forename: Anouk E
authors.initials: AE
authors.lastname: Muller
authors.affiliation: a Department of Acute and Critical Care Surgery , Washington University School of Medicine , Saint Louis , USA.
authors.forename: John E
authors.initials: JE
authors.lastname: Mazuski
mesh_terms: D053961:Azabicyclo Compounds / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001426:Bacterial Proteins / Q000037:antagonists & inhibitors; D002442:Ceftazidime / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D004338:Drug Combinations; D004755:Enterobacteriaceae / Q000187:drug effects / Q000201:enzymology; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D059413:Intraabdominal Infections / Q000188:drug therapy* / Q000382:microbiology; D007711:Klebsiella pneumoniae / Q000187:drug effects / Q000201:enzymology; D008795:Metronidazole / Q000627:therapeutic use; D065093:beta-Lactamase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001618:beta-Lactamases / Q000378:metabolism
chemical_list: D053961:Azabicyclo Compounds; D001426:Bacterial Proteins; D004338:Drug Combinations; C000595613:avibactam, ceftazidime drug combination; D065093:beta-Lactamase Inhibitors; D008795:Metronidazole; D002442:Ceftazidime; D001618:beta-Lactamases; C063912:carbapenemase
keywords: Antibiotic resistance; ceftazidime-avibactam; complicatedintra-abdominal infections; β-lactam-β-lactamase inhibitors