Some bacteria have already become resistant to ceftazidime/avibactam – one of the new antibiotics 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.
Antibiotic resistance occurs naturally, but it can be accelerated by increased use, whether the use is appropriate or not. 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.
HCPs must monitor and identify resistant bacteria
The UKHSA 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.
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 said 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 has launched a new digital campaign to tackle the threat of antibiotic resistance and help keep antibiotics working. The campaign is aimed at younger generations and is named after a new mascot, ‘Andi Biotic’. Over the six-week digital campaign, Andi will answer uncertainties people have about antibiotics, ensuring they understand when these medicines are appropriate, the importance of taking them only when prescribed, and why they should never be saved for future use.
Collaboration to keep antibiotics working
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.’
In February, the UKHSA widened the list of first-option antibiotics in an effort to tackle AMR.
Later that month, the National Audit Office warned that the Government has made ‘limited progress’ in achieving its vision of containing AMR and questioned the UK’s resilience to this public health threat. The public spending watchdog was joined by organisations such as the British Society for Antimicrobial Chemotherapy in urging the Government to invest in the NHS to ensure the healthcare workforce is fully equipped to tackle AMR.
Last year, research aimed at quantifying excess antibiotic use in an acute UK hospital found that nearly a quarter of antibiotic days of therapy were unnecessary.
A version of this article was originally published by our sister publication Nursing in Practice.
