Treatment of OXA-48 Producing Bacteria Infections

First-Line Treatment Options

• The International Journal of Antimicrobial Agents recommends ceftazidime/avibactam as the first-line treatment option for infections caused by OXA-48-like producing carbapenem-resistant Enterobacterales (CRE) 1, 2

Evidence Quality and Treatment Considerations

• The recommendation for ceftazidime/avibactam as first-line therapy has a CONDITIONAL strength with VERY LOW certainty of evidence, based on clinical data from observational studies with small sample sizes 1, 2
• Local epidemiology and resistance patterns should guide therapy decisions, as resistance to ceftazidime/avibactam in OXA-48 producers has been reported 1

Comparison with Other Carbapenemases

• For KPC-producing CRE, either ceftazidime/avibactam or meropenem/vaborbactam are recommended, with a stronger evidence base 1
• For MBL-producing CRE, ceftazidime/avibactam plus aztreonam is strongly recommended, with cefiderocol as an alternative 1, 2