Targeted Treatment:
- Severe infections caused by laboratory-confirmed carbapenem-resistant Enterobacterales or Pseudomonas aeruginosa (not Acinetobacter baumannii) susceptible to ceftazidime+avibactam (CAZ-AVI)
Empiric Use:
- Only in very select cases of seriously ill patients (e.g. patients with sepsis/septic shock):
- who have not responded to carbapenems if other causes of treatment failure have been excluded first and there is strong suspicion that the infection is caused by a carbapenem-resistant pathogen
- who have previously been treated for infections caused by carbapenem-resistant pathogens susceptible to CAZ-AVI
- who are known to be colonized with carbapenem-resistant pathogens susceptible to CAZ-AVI
Important Considerations:
- When used to treat complicated intra-abdominal infections CAZ-AVI should be given with metronidazole due to its unpredictable activity against anaerobes
- Since it is not active against metallo-β-lactamases (MBL), it is important to know the local epidemiology of the most prevalent genotypes for aerobic Gram-negative bacteria