Therapeutic indications for Ceftazidime –Avibactam
The Hellenic Society of (Antimicrobial) Chemotherapy (HSC) Consensus as of May 2018
In order to safeguard the appropriate use and effectiveness of this novel antibiotic versus Carbapenemase (KPC & OXA-48) Producing Enterobacteriaceae (CRE), HSC recommends the following:
- 1. Essential Precondition for Administration:
Consultation from an Infectious Diseases specialist, preferably a senior one, is essential.
- 2. Therapeutic Aims:
– Pan Drug Resistant (PDR) Gram negative bacteria producing KPC or OXA-48 with proven in vitro sensitivity to Ceftazidime/Avibactam.
– Infections from Extremely Drug Resistant (XDR) bacteria producing KPC or OXA-48 with proven in vitro sensitivity to Ceftazidime/Avibactam in patients with severe sepsis/septic shock or major comorbidities (ie haematologic malignancy, severe immunosuppression). In such cases combination treatment of Ceftazidime/Avibactam with a second in vitro active antimicrobial agent (ie colistin, tigecycline, fosfomycin, gentamicin) is possible and should be decided by the patient’s attending physician in cooperation with an infectious diseases specialist.
In less severe infections (ie skin and soft tissue infections, urinary tract infections) caused by such pathogens, monotherapy with in vitro sensitive agents such as aminoglycosides or tigecycline can be used instead of Ceftazidime/Avibactam.
– Infections from Pseudomonas aeruginosa when it is in vitro effective to no other antimicrobial agent other than Ceftazidime/Avibactam.