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Intravenous Ceftazidime-Avibactam in Extremely Premature Neonates With Carbapenem-Resistant Enterobacteriaceae: Two

Suzan S Asfour1, Faisal A Alaklobi2, Adli Abdelrahim3

  • 1Clinical Pharmacy Department (SSA), King Saud Medical City, Riyadh, Saudi Arabia.

The Journal of Pediatric Pharmacology and Therapeutics : JPPT : the Official Journal of PPAG
|March 4, 2022
PubMed

Insights

Ceftazidime-avibactam showed clinical cure in two premature neonates with carbapenem-resistant Enterobacteriaceae infections. Further randomized studies are needed to confirm safety and efficacy in neonates.

Area of Science:

  • Infectious Diseases
  • Neonatal Medicine
  • Pharmacology

Background:

  • Carbapenem-resistant Enterobacteriaceae (CRE) infections are increasing in Neonatal Intensive Care Units (NICUs).
  • CRE infections pose a significant clinical challenge, especially in extremely premature neonates.
  • Limited data exists on the use of ceftazidime-avibactam in neonatal populations.

Purpose of the Study:

  • To report the use of intravenous ceftazidime-avibactam in two extremely premature neonates with CRE infections.
  • To evaluate the clinical outcomes and safety of ceftazidime-avibactam in this vulnerable patient group.

Main Methods:

  • Retrospective case report of two extremely premature neonates treated with intravenous ceftazidime-avibactam.
  • Dosage was based on standard pediatric recommendations (62.5 mg/kg/dose every 8 hours) due to lack of neonatal-specific guidelines.
  • Infection types included bacteraemia and meningitis in one case, and bacteraemia only in the second case.

Main Results:

  • Both neonates achieved clinical cure after treatment with ceftazidime-avibactam.
  • Blood cultures turned sterile in the second case after treatment initiation.
  • Despite sterile blood cultures, the second patient died, likely due to sepsis, prematurity, or chronic lung disease.

Conclusions:

  • Intravenous ceftazidime-avibactam may be a potential treatment option for CRE infections in extremely premature neonates.
  • Further large-scale, randomized controlled trials are essential to establish the definitive safety and efficacy of ceftazidime-avibactam in neonates.
  • Neonatal-specific dosing and treatment protocols for ceftazidime-avibactam require further investigation.
Keywords:
bacteraemiacarbapenem-resistant Enterobacteriaceaeceftazidime-avibactammeningitisneonatal intensive care unitpremature neonates

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