Resistance emerging for one of newest antibiotics

Some bacteria have already become resistant to one of the new antibiotics ceftazidime/avibactam, introduced to the NHS in 2017.

A new study published by the UK Health Security Agency (UKHSA) highlights the risk, and although the levels of resistance are currently low, it provides a stark reminder that appropriate antibiotic use is essential to slowing the development of resistance.

Ceftazidime/avibactam treats some of the most serious hospital infections, such as bloodstream infections. The drug is a ‘reserve’ classified antibiotic and clinicians only prescribe it in exceptional circumstances, typically when patients have hard-to-treat infections caused by known multi-drug resistant bacteria, often when other antibiotics have failed.

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The researchers analysed data from routine surveillance samples between 2016 and 2020 to assess the levels of ceftazidime/avibactam testing, resistance and usage in England, providing baselines for future monitoring.

Routine surveillance samples provided reported ceftazidime/avibactam resistance categorisation and reference laboratory samples, allowing the assessment of minimum inhibitory concentration (MICs) and molecular data.

The analysis shows that 6.3% of bacteria tested in routine surveillance already showed resistance to the drug.

Resistance levels varied across bacterial species and fluctuated slightly over time, stabilising as routine surveillance testing was established. Nearly 70% of NHS trusts used the antibiotic during the study period.

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Dr Colin Brown, UKHSA deputy director responsible for antimicrobial resistance (AMR), said: ‘This study reminds us how important resistance surveillance is. Research like this means clinicians and prescribers can access the most relevant information available to prescribe the best antibiotics for their patients, while protecting the long-term effectiveness of antibiotics for future use.’

The researchers say that to treat infections effectively, carbapenemase gene detection and variant identification in ceftazidime/avibactam surveillance are important and suggest that healthcare professionals must monitor and identify resistant bacteria targeted by this antibiotic.

To support the initiatives to keep antibiotics working, the UKHSA launched a new digital campaign to tackle the threat of antibiotic resistance.

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Dr Brown added: ‘We aren’t going to be able to tackle antibiotic resistance solely by finding new drugs. While we continue to support innovation in developing new treatments, resistance will emerge, and so it’s important that we all work together to keep antibiotics working.’

A version of this article was first published by our sister title Nursing in Practice