Objective: The proportion of Gram-negative infections caused by carbapenem-resistant strains is increasing. Treatment options are limited by high toxicity rates, suboptimal pharmacokinetics and/or known microbiological resistance. Our aim was to assess in-hospital mortality, microbiologic cure and clinical success of an antimicrobial therapy with ceftazidime/avibactam.
Patients and Methods: We present a case series of 6 patients with infection caused by CRE who were treated with ceftazidime/avibactam therapy on a compassionate-use basis in a single Center.
Results: All isolates were classified as resistant to carbapenems. Ceftazidime/avibactam was used in combination therapy in 3 cases, in all cases as a carbapenem-sparing regimen. All patients experienced clinical and microbiological cure at the end of treatment. No in-hospital mortality occurred in this small cohort of patients. No difference in outcome was observed between monotherapy or combination therapy in terms of microbiological clearance or mortality. No relapses were documented.
Conclusions: Taken together, the data from this and other studies support the importance of ceftazidimeavibactam in the treatment of patients with CRE infections, including those who are acutely ill. However, we outline the fact that we must not be too confident on ceftazidime-avibactam as the solution for carbapenem-resistant Enterobacteriaceae as report of relapse, resistance, and clinical failure are increasing.