Elevated MICs of Susceptible Antipseudomonal Cephalosporins in Non-Carbapenemase-Producing, Carbapenem-Resistant Pseudomonas aeruginosa: Implications for Dose Optimization

Antimicrob Agents Chemother. 2021 Oct 18;65(11):e0120421. doi: 10.1128/AAC.01204-21. Epub 2021 Aug 16.

Abstract

The present study evaluated the in vitro potency of ceftazidime and cefepime among carbapenem-resistant Pseudomonas aeruginosa isolates collected as part of a global surveillance program and assessed the pharmacodynamic implications using previously published population pharmacokinetics. When susceptible, MICs resulted at the high end of distribution for both ceftazidime and cefepime, thus 6 g/day was required to achieve optimal pharmacodynamic profiles. These findings should be considered in the clinic and for the application of CLSI susceptibility breakpoints.

Keywords: Pseudomonas aeruginosa; carbapenem resistance; cefepime; ceftazidime; pharmacodynamics; pharmacokinetics.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Azabicyclo Compounds
  • Carbapenems / pharmacology
  • Ceftazidime / pharmacology
  • Cephalosporins* / pharmacology
  • Humans
  • Microbial Sensitivity Tests
  • Pseudomonas Infections* / drug therapy
  • Pseudomonas aeruginosa

Substances

  • Anti-Bacterial Agents
  • Azabicyclo Compounds
  • Carbapenems
  • Cephalosporins
  • Ceftazidime