Background and Importance Ceftazidime/avibactam is a combination antibiotic treatment considered to be of restricted use due to its novelty and low resistance. Its use is justified as a targeted therapy in the presence of multi-resistant gram-negative aerobic bacteria according to the antibiotic optimisation programme protocol.

Aim and Objectives To analyse the use and prescribing services of ceftazidime/avibactam in inpatients during 365 days.

Material and Methods A retrospective and descriptive observational study of the use of ceftazidime/avibactam during a 24-month period in the Hospital Universitario Torrecárdenas was carried out, analysing 46 patients. Data were extracted from the clinical database of the Andalusian Health System (Diraya), the database of the laboratories of Almeria (Modulab) and the location of the treatment was consulted in the Dominion – Unidosis database.

Results The group analysed consisted of 46 patients of whom 16 died, and of the total of 30 survivors, four were still in hospital at the time of the study.

The group consisted of 26% women and 74% men. Mortality in females was 33% compared to 35% in males. Total mortality was 37%.

Of the total, 48% received a targeted treatment for a multi-resistant bacterium, with 10% prescribed by the infectious disease service and 38% by other services. Only 28% were targeted treatments for multi-resistant gram- resistant bacteria.

In contrast, 52% of the total received ceftazidime/avibactam as empirical treatment. In 37% of the empirical cases the bacteria were found to be non-resistant.

Of the 48% of targeted treatments:

20% of gram-positive

1 Staphylococcus petrasii

5 Staphylococcus epidermidis MRSA

2 Staphylococcus haemoliticum MRSA

1 Staphylococcus aureus MRSA

28% of gram-negative

7 Pseudomona aeruginosa mR

1 Escherichia coli OXA-48

1 Klebsiella pneumoniae BLEA

1 Enterococcus faecium VanR

3 Stenotrophomonas maltophila

Conclusion and Relevance The data revealed by the study do not conform to the centre protocol highlighting its use as empirical and targeted treatment for gram-positives. Ceftazidime/avibactam is considered to be of extremely restricted use limited by antibiograms or sepsis codes in the presence of multidrug-resistant gram-positive bacteria.

Conflict of Interest No conflict of interest.