Exercise no. 334 Cefepime + enmetazobactam(EXBLIFEP°) in complicated urinary tract infections and hospital-acquired pneumonia

"Complicated" urinary tract infections or hospital-acquired pneumonia are often caused by Gram-negative bacteria, in particular enterobacteria and Pseudomonas aeruginosa. When the infection is serious, a broad-spectrum antibiotic such as a "third-generation" cephalosporin or a carbapenem is an option of choice. Another option is the combination of the penicillin piperacillin + the beta-lactamase inhibitor tazobactam. The growing use of these antibiotics is contributing to the increasing incidence of infections with bacteria that produce "extended-spectrum" beta-lactamases (including carbapenemases), enzymes that reduce the efficacy of many antibiotics. When a serious infection with an extended-spectrum beta-lactamase-producing bacterium is suspected on the basis of clinical criteria or confirmed in vitro, a combination of a broad-spectrum antibiotic with a beta-lactamase inhibitor is sometimes useful, such as: the cephalosporin ceftazidime + avibactam; or the carbapenem meropenem + vaborbactam.