A new antibiotic for hard-to-treat gram-negative infections

Hospital-acquired pneumonia, including ventilator-associated pneumonia, is one of the infections this new antibiotic is approved to be used for. — AFP

Antibiotic, or antimicrobial, resistance is one of the biggest threats to public health in the world.

Antibiotics are very effective drugs in treating various bacterial infections.

However, excessive and unnecessary use of these medications promotes the evolution of bacteria that are resistant to the effects of these drugs, rendering them useless.

“Today, antimicrobial resistance is one of the biggest threats to global health, impacting our ability to treat serious infections and provide standard medical procedures, and influencing public healthcare outcomes and costs.

“Antimicrobial medicines, especially antibiotics, are among the most precious medical resources the world has ever known, but more and more incidents of resistant infections are being reported, including by Gram-negative bacteria,” said consultant infectious disease physician and national Infectious Disease head Datuk Dr Mahiran Mustafa.

She added that all stakeholders need to play their part if there is to be any significant headway in mitigating the threat of antimicrobial resistance.

“Healthcare providers will need to prescribe antibiotics appropriately and adequately, while members of the public will need to use antibiotics responsibly,” she said, adding that the efforts of the pharmaceutical industry is also key.

Infectious disease physician Dr Asok Kurup noted that: “For multifactorial reasons including inappropriate antibiotic use and poor infection control standards, antibiotic resistance has become a major threat in healthcare settings universally, and our region is not spared.

“Gram-negative bacteria in particular are becoming more resistant not only to typical antibiotics, but also to broad-spectrum ones like carbapenems.

“Infections implicating these multidrug-resistant organisms are associated with higher morbidity, mortality and cost, compared with (drug-)susceptible infections.

“Moreover, there is an imperative to treat these infections early to prevent adverse outcomes.

“Up until recently, managing these difficult-to-treat infections have been very challenging, given the inadequacies of available therapeutic agents, or toxicities.”

Failure to treat early and appropriately has been associated with poor outcomes in patients with serious Gram-negative infections, although early treatment must consider patient risk factors, as well as local epidemiology.

The good news is that a new combination antibiotic, developed to treat serious Gram-negative bacterial infections requiring hospitalisation, was recently launched in Malaysia.

Named Zavicefta, it is a combination of ceftazidime, a third- generation antipseudomonal cephalosporin, and avibactam, a beta-lactamase inhibitor.

It is currently indicated for the treatment of those 18 years and above with complicated intra-abdominal infection, in combination with metronidazole; complicated urinary tract infection, including pyelonephritis; and hospital-acquired pneumonia, including ventilator-associated pneumonia.

It has a well-established efficacy and safety profile.Said Pfizer country medical director for Malaysia Dr Jerusha Naidoo: “Early, adequate antibiotic therapy is crucial for patients with serious Gram-negative infections to avoid increased healthcare utilisation, cost and mortality.

"We hope Malaysians will be able to benefit from Zavicefta when needed.”

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