Exploring New Treatment Options for Resistant Gram-Negative Bacteria

Segment Description: Ellie J. C. Goldstein, MD, director of the R.M. Alden Research Laboratory and clinical professor at the UCLA School of Medicine, discusses the global threat of resistant gram-negative rods and recently approved drugs ceftolozane tazobactam and ceftazidime avibactam.

Interview Transcript (modified slightly for readability):

“The Infectious Disease Society of America (IDSA) noted that resistance was increasing and the US Centers for Disease Control and Prevention (CDC) has made resistant gram-negative rods an urgent global threat. The IDSA initiated at least 2 programs: 1 was 10 x ‘20—having 10 new drugs by 2020—and the other is the ‘Bad Bugs, No Drugs’; both of these highlight the problem that there is a lot of resistance developed in the gram-negative sphere in particular.

This may be less of a problem in the United States and more of a problem elsewhere but with international travel and people going on vacation and flying back, they bring their microbiome from where they have visited [back] home. And so, resistance has been increasing worldwide and in the United States.

As part of the effort to get those ‘10 by 20,’ 2 new gram-negative drugs have been recently approved by the US Food and Drug Administration (FDA); one [is] ceftolozane tazobactam and the other [is] ceftazidime avibactam and they are part of this effort to get new drugs for resistant gram-negative infections. These drugs are actually very different—they’re not interchangeable; they’re not the same.

Ceftolozane is a new cephalosporin. Some people might call it a fifth generation, with an old b-lactamase inhibitor tazobactam, and its particular strength is against resistant Pseudomonas, including ceftazidime-resistant Pseudomonas.

Ceftazidime avibactam is a drug with an old cephalosporin but a new b-lactamase inhibitor that has particular strength against carbapenem-resistant Enterobacteriaceae (CREs) like Klebsiella pneumonia.

The 2 drugs have different niches in the therapeutic armamentarium and so, each 1 is different and depends on what you want to treat; you want to be specific for your individual patient depending on their isolate and their disease.”