3児の親さん薬剤師のブログ

とある薬剤師です。感染症治療を考える素材をちょこっと提供。noteもあります https://note.com/twin1980

Evaluation of Ceftolozane-Tazobactam in Combination with Meropenem against Pseudomonas aeruginosa Sequence Type 175 in a Hollow-Fiber Infection Model.

AACに報告された、XDR P. aeruginosa に対する、コンビネーション探索。

 

www.ncbi.nlm.nih.gov

感想

 

  • なんだか凄い爆撃で、 XDR P. aeruginosa 感染症治療の可能性をつかんだ。

 

note

 

  • MEPM + ceftolozane-tazobactam

 

Abstract

 

The aim of this study was to investigate the efficacy of ceftolozane-tazobactam in combination with meropenem against an extensively drug-resistant (XDR) Pseudomonas aeruginosa high-risk clone, sequence type 175, isolated in a Spanish university hospital. A 14-day hollow-fiber infection model was used to simulate clinical exposure of the two drug regimens alone and in combination, and serial samples were collected to determine drug concentrations and CFU counts. The untreated control failed, as did each study regimen when administered alone. However, when ceftolozane-tazobactam was administered in combination with meropenem, there was a >4-log10 CFU/ml bacterial density reduction and suppression of resistance for the duration of the study. These data suggest that ceftolozane-tazobactam plus meropenem may be a useful combination for treating XDR P. aeruginosa.

 

備考 

  • ZERBAXA  : ceftolozane and tazobactam
  • ZERBAXA used in combination with metronidazole is indicated in adult patients for the treatment of complicated intra-abdominal infections (cIAI) caused by the following Gram-negative and Gram-positive microorganismss.

Ceftolozane/Tazobactam: A New Option in the Treatment of Complicated Gram-Negative Infections

https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/206829lbl.pdf

 

Ceftolozane-tazobactam 

 

Ceftolozane is a novel cephalosporin whose gram-negative activity is expanded by the addition of tazobactam. The combination has broad-spectrum in vitro activity against aerobic and facultative gram-negative bacilli, including P. aeruginosa and most extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae. It has limited gram-positive activity against streptococci. Enterococcal and staphylococcal species are generally resistant. In clinical trials, clinical cure rates with ceftolozane-tazobactam were similar to those with levofloxacin for complicated urinary tract infection caused by levofloxacin-susceptible organisms and, when combined with metronidazole, were similar to those with meropenem for complicated intra-abdominal infections. Ceftolozane-tazobactam also performed favorably against infections caused by ESBL-producing isolates in these trials. It is also effective in treating carbapenem-resistant, ceftolozane-tazobactam susceptible P. aeruginosa pneumonia, as illustrated in a small multicenter, retrospective study. Efficacy of ceftolozane-tazobactam may be attenuated in patients with renal impairment (estimated glomerular filtration rate [GFR] <50 mL/min).

 

www.ncbi.nlm.nih.gov

www.ncbi.nlm.nih.gov

www.ncbi.nlm.nih.gov