New Perspectives on Antimicrobial Agents: Ceftolozane-Tazobactam

Area of Science:

• Infectious Diseases
• Pharmacology
• Antimicrobial Resistance

Background:

• Ceftolozane-tazobactam (C/T) is an approved fifth-generation cephalosporin/beta-lactamase inhibitor combination.
• It is indicated for complicated intra-abdominal infections, complicated urinary tract infections, and hospital-acquired pneumonia in adults.

Purpose of the Study:

• To review the pharmacology of C/T.
• To focus on clinical trial and real-world data supporting C/T utilization.
• To describe current C/T usage patterns at Barnes-Jewish Hospital (BJH).

Main Methods:

• Review of pharmacology.
• Synthesis of emerging clinical trial and real-world data.
• Analysis of institutional (BJH) prescribing practices.

Main Results:

• C/T is used as directed monotherapy at BJH for Pseudomonas aeruginosa isolates resistant to other beta-lactams.
• Empirical C/T use at BJH is reserved for specific high-risk situations prior to pathogen identification.
• High-risk situations include critically ill ICU patients, carbapenem treatment failures, and patients with known MDR P. aeruginosa risks.

Conclusions:

• Ceftolozane-tazobactam is a valuable agent for infections involving multidrug-resistant Pseudomonas aeruginosa.
• Clinical data support its use in specific scenarios, guiding institutional prescribing.
• Understanding C/T pharmacology and resistance patterns is crucial for optimizing patient care.