Place in therapy

Place in therapy

Published data were available for the use of ceftazidime/avibactam for complicated intra‑abdominal infections and complicated urinary tract infections in adults. There were no published randomised controlled trial (RCT) data for using ceftazidime/avibactam to treat hospital-acquired pneumonia or to treat aerobic gram‑negative infections with limited treatment options and so the likely place of therapy for these 2 indications is unclear.

Local decision makers need to take safety, efficacy, cost and patient factors into account when considering the likely place in therapy of ceftazidime/avibactam for its licensed indications. The European Public Assessment Report [EPAR]: ceftazidime/avibactam states that ceftazidime/avibactam is active against ceftazidime-resistant and many carbapenem-resistant clinical isolates of Enterobacteriaceae and Pseudomonas aeruginosa when assessed in vitro and in vivo. However, there is limited evidence that ceftazidime/avibactam is effective in treating people with ceftazidime‑resistant pathogens. The EPAR also states that very few pathogens expressing serine carbapenemases have been treated with ceftazidime/avibactam. Specialists involved in reviewing this evidence summary have suggested that ceftazidime/avibactam is likely to be a treatment option for complicated intra‑abdominal infections and complicated urinary tract infections if a person's infection does not respond to commonly used antimicrobials and when there is known resistance to other antimicrobials. Use of ceftazidime/avibactam will need to be informed by understanding the mechanisms by which pathogens evolve to develop resistance.

Commissioners and local decision makers will need to consider where ceftazidime/avibactam fits within local hospital antimicrobial policies and guidelines for managing complicated intra-abdominal infections, complicated urinary tract infections, hospital‑acquired pneumonia and treating infections due to aerobic gram‑negative organisms in adults with limited treatment options, taking account of the principles of antimicrobial stewardship.

ISBN: 978-1-4731-2471-4