Real-world in vitro activity of newer antibiotics against Enterobacterales and Pseudomonas aeruginosa, including carbapenem-non-susceptible and multidrug-resistant isolates: a multicenter analysis

Microbiol Spectr. 2023 Dec 12;11(6):e0312923. doi: 10.1128/spectrum.03129-23. Epub 2023 Nov 8.

Abstract

Newer antibiotics against Gram-negative pathogens provide important treatment options, especially for antibiotic-resistant bacteria, but little is known about their use during routine clinical care. To use these agents appropriately, clinicians need to have access to timely susceptibility data. We evaluated 27,531 facility-reported susceptibility results from the BD Insights Research Database to gain a better understanding of real-world testing practices and susceptibility rates for six newer antibiotics. Escherichia coli was the most frequently tested potential pathogen, and ceftazidime-avibactam and ceftolozane-tazobactam had the greatest numbers of susceptibility results. For cefiderocol, eravacycline, imipenem-relabactam, and meropenem-vaborbactam, susceptibility data were available for fewer than 2% of isolates. Susceptibility comparisons should be considered with caution. Ceftazidime-avibactam had the highest susceptibility rates for Enterobacterales while cefiderocol had the highest susceptibility rates for Pseudomonas aeruginosa. New antibiotics have the potential to improve the management of Gram-negative infections, but their use may be hampered by the absence of susceptibility data.

Keywords: Enterobacterales; Gram-negative pathogens; Pseudomonas aeruginosa; antibiotic resistance; carbapenem resistance; ceftazidime–avibactam; multidrug resistance.

Publication types

  • Multicenter Study

MeSH terms

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

Substances

  • Anti-Bacterial Agents
  • Carbapenems
  • Cephalosporins
  • Cefiderocol