Ceftazidime-avibactam, ceftolozane-tazobactam safe for use in children

Treatment with either ceftazidime-avibactam (CAZ/AVI) or ceftolozane-tazobactam (C/T) is well tolerated and effective in children infected with Gram-negative pathogens resistant to carbapenems, a recent study has shown.

A total of 50 CAZ/AVI and 25 C/T prescriptions were included in the analysis, involving 21 and 20 patients, respectively. All participants had an underlying chronic condition.

Most of the prescriptions were initiated by paediatric intensive care units and the Department of Pediatric Pulmonology for the treatment of respiratory tract infections (CAZ/AVI: n=41/50, 82 percent; C/T: n=14/25, 56 percent). The most common pathogen was Pseudomonas aeruginosa (CAZ/AVI: n=26/48, 54 percent; C/T: n=16/19, 84 percent).

Nearly all prescriptions of CAZ/AVI (n=47/50, 94 percent) and C/T (n=23/25, 92 percent) were deemed appropriate by the antimicrobial stewardship (AMS) team. 

Both treatments showed good tolerability and clinical success in 33 (66 percent) and 19 (76 percent) patients treated with CAZ/AVI and C/T, respectively.

In this study, researchers retrospectively analysed all CAZ/AVI or C/T prescriptions in children hospitalized in a French tertiary hospital between 2017 and 2022. They collected clinical, biological, and pharmacological data prospectively as part of the antibiotic monitoring program set by the AMS team.

“Infections caused by drug-resistant Gram-negative bacteria, including carbapenem-resistant Enterobacterales and P. aeruginosa, are emerging in paediatric hospitals,” the researchers said. “New ß-lactam/ß-lactamase inhibitor combinations exhibit activity against these pathogens.”