New Perspectives on Antimicrobial Agents: Ceftolozane-Tazobactam

• Published in: Antimicrobial agents and chemotherapy Vol. 65; no. 7; p. e0231820
• Main Authors: Lizza, Bryan D, Betthauser, Kevin D, Ritchie, David J, Micek, Scott T, Kollef, Marin H
• Format: Journal Article
• Language: English
• Published: United States American Society for Microbiology 17-06-2021
• Subjects: Adult; Anti-Bacterial Agents - pharmacology; Anti-Bacterial Agents - therapeutic use; Cephalosporins - pharmacology; Drug Resistance, Multiple, Bacterial; Humans; Microbial Sensitivity Tests; Perspective; Pseudomonas aeruginosa; Pseudomonas Infections - drug therapy; Tazobactam - pharmacology; antimicrobial resistance
• ISSN: 0066-4804; 1098-6596
• DOI: 10.1128/AAC.02318-20

Ceftolozane-tazobactam (C/T) is a new fifth-generation cephalosporin/beta-lactamase inhibitor combination approved by the Food and Drug Administration and the European Medicines Agency for treatment of complicated intraabdominal infections, complicated urinary tract infections, and hospital-acquired pneumonia in adult patients. This review will briefly describe the pharmacology of C/T and focus on the emerging clinical trial and real-world data supporting its current utilization. Additionally, our synthesis of these data over time has set our current usage of C/T at Barnes-Jewish Hospital (BJH). C/T is primarily employed as directed monotherapy at BJH when Pseudomonas aeruginosa isolates are identified with resistance to other beta-lactams. C/T can also be used empirically in specific clinical situations at BJH prior to microbiological detection of an antibiotic-resistant P. aeruginosa isolate. These situations include critically ill patients in the intensive care unit (ICU) setting, where there is a high likelihood of infection with multidrug-resistant (MDR) P. aeruginosa; patients failing therapy with a carbapenem; specific patient populations known to be at high risk for infection with MDR P. aeruginosa (e.g., lung transplant and cystic fibrosis patients); and patients know to have previous infection or colonization with MDR P. aeruginosa.