Ceftolozane/tazobactam: place in therapy

  • Expert Rev Anti Infect Ther. 2018 Apr;16(4):307-320. doi: 10.1080/14787210.2018.1447381.
Daniele Roberto Giacobbe  1 ,  Matteo Bassetti  2 ,  Francesco Giuseppe De Rosa  3 ,  Valerio Del Bono  1 ,  Paolo Antonio Grossi  4 ,  Francesco Menichetti  5 ,  Federico Pea  6 ,  Gian Maria Rossolini  7  8 ,  Mario Tumbarello  9 ,  Pierluigi Viale  10 ,  Claudio Viscoli  1 ,  ISGRI-SITA (Italian Study Group on Resistant Infections of the Società Italiana Terapia Antinfettiva)
Affiliations
  • 1. a Infectious Diseases Unit, Ospedale Policlinico San Martino - IRCCS per l'Oncologia and Department of Health Sciences , University of Genoa , Genoa , Italy.
  • 2. b Infectious Diseases Clinic, Department of Medicine , University of Udine and Azienda Sanitaria Universitaria Integrata Presidio Ospedaliero Universitario Santa Maria della Misericordia , Udine , Italy.
  • 3. c Department of Medical Sciences , University of Turin, Infectious Diseases, City of Health and Sciences , Turin , Italy.
  • 4. d Department of Surgical and Morphological Sciences of Clinical Medicine , University of Insubria , Varese , Italy.
  • 5. e Infectious Diseases Clinic , Nuovo Santa Chiara University Hospital, Azienda Ospedaliera Universitaria Pisana , Pisa , Italy.
  • 6. f Institute of Clinical Pharmacology , Department of Medicine, University of Udine and Azienda Sanitaria Universitaria Integrata Presidio Ospedaliero Universitario Santa Maria della Misericordia , Udine , Italy.
  • 7. g Department of Experimental and Clinical Medicine , University of Florence , Florence , Italy.
  • 8. h Clinical Microbiology and Virology Unit , Florence Careggi University Hospital , Florence , Italy.
  • 9. i Institute of Infectious Diseases , Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli , Rome , Italy.
  • 10. j Department of Medical and Surgical Sciences , University of Bologna , Bologna , Italy.
PMID: 29493397 DOI: 10.1080/14787210.2018.1447381
Abstract

Ceftolozane/tazobactam (C/T) is a new Antibiotic resulting from the combination of a novel cephalosporin, structurally similar to ceftazidime, with tazobactam, a well-known Beta-lactamase Inhibitor. C/T remains active against extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae and multi-drug resistant (MDR) P. aeruginosa, and has been recently approved for the treatment of complicated intra-abdominal infections (cIAI) and complicated urinary tract infections (cUTI). A trial on hospital-acquired pneumonia is ongoing. Areas covered: The place in therapy of C/T is delineated by addressing the following main topics: (i) antimicrobial properties; (ii) pharmacological properties; (iii) results of clinical studies. Expert commentary: C/T is approved for cIAI and cUTI. However, the drug has a special value for clinicians in any kind of infectious localization for two main reasons. The first is that C/T is especially valuable in suspected or documented severe infections due to MDR P. aeruginosa, which is not a rare occurrence in many countries. The second is that C/T may provide an alternative to carbapenems for the treatment of infections caused by ESBL-producers, thus allowing a carbapenem-sparing strategy. Reporting of off-label use is mandatory to increase the body of evidence and the clinicians' confidence in using it for indications Other than cIAI and cUTI.

Keywords
Antimicrobial resistance; ESBL; Enterobacteriaceae; MDR; Pseudomonas; carbapenem-sparing; ceftolozane; tazobactam.
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