Activity of ertapenem/zidebactam (WCK 6777) against problem Enterobacterales.
J Antimicrob Chemother
; 77(10): 2772-2778, 2022 09 30.
Article
in English
| MEDLINE | ID: covidwho-1992223
ABSTRACT
BACKGROUND:
Secondary healthcare will remain pressured for some years, both because SARS-CoV-2 will circulate as a nosocomial pathogen, and owing to backlogs of patients awaiting delayed elective procedures. These stresses will drive the use of Outpatient Parenteral Antibiotic Therapy (OPAT), which will need to cover increasingly resistant Gram-negative opportunists. We evaluated the activity of ertapenem/zidebactam, proposed for 2â+â2â g q24h administration. MATERIALS ANDMETHODS:
MICs were determined, by BSAC agar dilution, for 1632 Enterobacterales submitted to the UK national reference laboratory for investigation of antimicrobial resistance.RESULTS:
Over 90% of Escherichia coli with AmpC, ESBLs, KPC, metallo- or OXA-48 carbapenemases were inhibited by ertapenem/zidebactam 11 at ertapenem's current 0.5â mg/L breakpoint. For other major Enterobacterales, the proportions inhibited by ertapenem/zidebactam 11 at 0.5â mg/L were mostly 65% to 90% but were lower for Klebsiella pneumoniae/oxytoca with metallo- or OXA-48 ß-lactamases. However, animal studies support an 8â mg/L breakpoint for ertapenem/zidebactam, based on a shortened T>MIC being needed compared with ertapenem alone. On this basis ertapenem/zidebactam would count as active against 90%-100% of isolates in all groups except K. pneumoniae/oxytoca with MBLs (±OXA-48), where MICs and percent susceptibility vary substantially even with inocula within the BSAC acceptable range.CONCLUSIONS:
Ertapenem/zidebactam has a proposed once-daily regimen well suited to OPAT. Even on highly conservative breakpoint projections, it has potential against MDR E. coli, including metallo-carbapenemase producers. If trial data sustain the 8â mg/L breakpoint indicated by animal experiments, its potential will extend widely across infections due to ESBL-, AmpC- and carbapenemase-producing Enterobacterales.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Escherichia coli
/
COVID-19
Type of study:
Experimental Studies
/
Randomized controlled trials
Limits:
Humans
Language:
English
Journal:
J Antimicrob Chemother
Year:
2022
Document Type:
Article
Affiliation country:
Jac
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