Information below is specific to the use of medicines in the adult setting.
The (non cystic fibrosis) use of carbapenems (e.g. meropenem) in NHSGGC has more than doubled since early 2010. The potential consequence of this is increased emergence of multi-drug resistant gram negative bacteria (MDRGNB) and in particular, resistance to piperacillin/tazobactam (Tazocin®) and carbapenems (antibiotics usually of last resort). Cases of carbapenem resistant Klebsiella and Escherichia coli have been reported throughout the UK.
The Antimicrobial Management Team is strategically introducing 2 antibiotics (aztreonam and temocillin) into guidance, as alternative options to carbapenems and piperacillin/tazobactam, to reduce emergence of MDRGNB.
Increased use of these antibiotics will have financial implications as both are more expensive than piperacillin/tazobactam and carbapenems. However in the long term this will be less than the cost of treating carbapenem resistant bacteria.
AZTREONAM KEY MESSAGES
TEMOCILLIN KEY MESSAGES
REMEMBER
MDRGNB are increasing worldwide and prudent prescribing of carbapenems and piperacillin/tazobactam is essential in combating this threat.
Aztreonam and temocillin are alternative options to carbapenems and piperacillin/tazobactam to reduce the emergence of MDRGNB.