New antibiotic-beta lactamase inhibitor combination pushes back the looming threat of antibiotic resistance

A new antibiotic-beta lactamase combination has been approved for the treatment of complicated intra-abdominal infection (cIAI) in combination with metronidazole, complicated urinary tract infection (cUTI) including pyelonephritis, and hospital-acquired pneumonia (HAP) including ventilator-associated pneumonia (VAP).

The new drug combination consists of ceftazidime, a class of cephalosporin; and avibactam, a beta-lactamase inhibitor and is traded as Zavicefta®(Pfizer). Speaking at the launch announcement, Dr Asok Kurup, an infectious disease physician in Singapore, said: “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.”

Kurup also noted gram-negative bacteria, in particular, are becoming resistant to both standard antibiotics and broad-spectrum antibiotics such as carbapenems. Infections caused by these multidrug resistant organisms (MDRO) have a higher morbidity, mortality, and incur higher cost than susceptible infections. Furthermore, it is critical to treat these infections as soon as possible to avoid negative outcomes. Up until recently, managing these difficult-to-treat infections was extremely problematic due to lack of available therapeutic agents or toxicities.

Aligned with Kurup’s sentiments, Dato’ Dr Mahiran Mustafa, senior consultant infectious disease physician, said: “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.” Mahiran is also national head of Infectious Disease Services at the Ministry of Health Malaysia.

Dr Jerusha Naidoo, Pfizer’s country medical director for Malaysia, said Zavicefta was developed to help patients suffering from serious infectious diseases by addressing difficult-to-treat gram-negative bacteria, many of which have become increasingly resistant to currently available antibiotics. She iterated that the introduction of ceftazidime/avibactam is a testament to Pfizer’s commitment to addressing the rising threat of antibiotic resistance through research and development of a more robust antibiotics pipeline.

Antibiotic resistance reaching a tipping point, stakeholders take note
Mahiran called for multiple stakeholders to play their part in addressing antimicrobial resistance (AMR) for there to be any significant headway in mitigating this imminent threat. “Healthcare providers will need to prescribe antibiotics appropriately and adequately, while members of the public will need to use antibiotics responsibly. The efforts of the pharmaceutical industry is key and we appreciate the leading role Pfizer plays in global antimicrobial R&D and stewardship.”

Pfizer runs one of the largest and most accessible AMR surveillance programmes in the world, called the Antimicrobial Testing Leadership and Surveillance (ATLAS) database. The platform provides public access to both antifungal and antibacterial resistance data through a single resource, enabling decision makers to adapt stewardship and infection control and prevention programmes. The company is also one of the contributors to the AMR Action Fund, a collaboration among more than 20 biopharmaceutical companies that aims to bring two to four new antibiotics to patients by 2030 through collaboration between pharmaceutical companies, philanthropies, development banks and multilateral organizations.