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Table 2 Activity of ceftazidime-avibactam and comparator agents against levofloxacin-resistant E. coli; ATLAS, by region, 2012–2018

From: Antimicrobial activity of ceftazidime-avibactam and comparators against levofloxacin-resistant Escherichia coli collected from four geographic regions, 2012–2018

Antimicrobial MIC50
(mg/L)
MIC90
(mg/L)
Range
(mg/L)
%S %I %R
Africa/Middle East, ESBL-positive (N = 609)     
Ceftazidime-avibactam 0.25 0.5  ≤ 0.015– ≥ 256 99.7 0.3
Ceftazidimea 32 128 0.12– ≥ 256 2.8 13.3 83.9
Cefepimea 32  ≥ 64 0.25– ≥ 64 2.5 7.2 90.3
Ampicillin  ≥ 64  ≥ 64 16– ≥ 64 0.0 100
Amoxicillin-clavulanatea 16 32 1– ≥ 64 26.9 73.1
Piperacillin-tazobactam 8 128  ≤ 0.25– ≥ 256 61.1 18.2 20.7
Aztreonama 64 128 2– ≥ 256 0.0 5.3 94.7
Imipenem 0.25 0.25 0.06– ≥ 16 99.3 0.3 0.3
Meropenem 0.03 0.06 0.015– ≥ 32 99.5 0.3 0.2
Colistinb (N = 472) 0.5 1  ≤ 0.06–8 99.2 0.8
Amikacin 4 16 0.5– ≥ 128 85.2 14.8
Tigecycline 0.25 0.5 0.06–4 96.2 3.8
Africa/Middle East, ESBL-negative (N = 532)     
Ceftazidime-avibactam 0.12 0.25  ≤ 0.015– ≥ 256 99.6 0.4
Ceftazidime 0.25 0.5  ≤ 0.015– ≥ 256 93.0 1.3 5.6
Cefepime  ≤ 0.12 1  ≤ 0.12– ≥ 64 92.7 3.2 4.1
Ampicillin  ≥ 64  ≥ 64 1– ≥ 64 15.0 85.0
Amoxicillin-clavulanate 8 32  ≤ 0.12– ≥ 64 56.0 44.0
Piperacillin-tazobactam 2 32 0.5– ≥ 256 82.3 5.6 12.0
Aztreonam 0.12 0.5  ≤ 0.015– ≥ 256 93.0 1.5 5.5
Imipenem 0.12 0.25 0.06– ≥ 16 99.1 0.4 0.6
Meropenem 0.03 0.06 0.008–16 99.2 0.2 0.6
Colistinb (N = 413) 0.25 1  ≤ 0.06– ≥ 16 98.5 1.5
Amikacin 2 8 0.5– ≥ 128 94.4 5.6
Tigecycline 0.25 0.5 0.06–4 94.9 5.1
Asia/South Pacific, ESBL-positive (N = 1283)     
Ceftazidime-avibactam 0.12 0.5  ≤ 0.015– ≥ 256 97.0 3.0
Ceftazidimea 16 128 0.25– ≥ 256 6.3 16.4 77.3
Cefepimea 32  ≥ 64  ≤ 0.12– ≥ 64 1.5 11.0 87.5
Ampicillin  ≥ 64  ≥ 64 4– ≥ 64 0.2 99.8
Amoxicillin-clavulanatea 16 32 2– ≥ 64 41.6 58.4
Piperacillin-tazobactam 4 128 0.5– ≥ 256 74.0 9.8 16.1
Aztreonama 32 128 0.06– ≥ 256 0.5 7.9 91.7
Imipenem 0.25 0.5  ≤ 0.03– ≥ 16 96.5 0.3 3.2
Meropenem 0.03 0.12 0.008– ≥ 32 96.5 0.5 3.0
Colistinb (N = 1012) 0.25 1  ≤ 0.06– ≥ 16 98.8 1.2
Amikacin 4 16 0.5– ≥ 128 89.8 10.2
Tigecycline 0.25 0.5 0.03– ≥ 16 94.3 5.7
Asia/South Pacific, ESBL-negative (N = 1054)     
Ceftazidime-avibactam 0.12 0.25  ≤ 0.015– ≥ 256 99.4 0.6
Ceftazidime 0.25 32  ≤ 0.015– ≥ 256 77.9 3.1 19.0
Cefepime  ≤ 0.12 1  ≤ 0.12– ≥ 64 91.4 3.9 4.7
Ampicillin  ≥ 64  ≥ 64  ≤ 0.5– ≥ 64 17.0 83.0
Amoxicillin-clavulanate 8 32  ≤ 0.12– ≥ 64 52.4 47.6
Piperacillin-tazobactam 2 32 0.25– ≥ 256 83.5 4.9 11.6
Aztreonam 0.12 16  ≤ 0.015– ≥ 256 79.7 4.6 15.7
Imipenem 0.25 0.5  ≤ 0.03– ≥ 16 99.3 0.2 0.5
Meropenem 0.03 0.06  ≤ 0.004– ≥ 32 99.4 0.1 0.5
Colistinb (N = 780) 0.25 1  ≤ 0.06– ≥ 16 99.4 0.6
Amikacin 2 8  ≤ 0.25– ≥ 128 96.5 3.5
Tigecycline 0.25 0.5 0.03–4 94.7 5.3
Europe, ESBL-positive (N = 2290)      
Ceftazidime-avibactam 0.12 0.5  ≤ 0.015– ≥ 256 99.6 0.4
Ceftazidimea 16 128 0.12– ≥ 256 6.0 17.2 76.9
Cefepimea 32  ≥ 64  ≤ 0.12– ≥ 64 4.6 12.6 82.8
Ampicillin  ≥ 64  ≥ 64 1– ≥ 64 0.3 99.7
Amoxicillin-clavulanatea 16 32  ≤ 0.12– ≥ 64 25.9 74.1
Piperacillin-tazobactam 8 128  ≤ 0.25– ≥ 256 61.3 15.8 22.9
Aztreonama 32 128 0.5– ≥ 256 0.3 10.3 89.4
Imipenem 0.25 0.25  ≤ 0.03– ≥ 16 99.0 0.4 0.6
Meropenem 0.03 0.06  ≤ 0.004– ≥ 32 98.9 0.6 0.5
Colistinb (N = 1754) 0.5 1  ≤ 0.06– ≥ 16 99.1 0.9
Amikacin 4 16 0.5– ≥ 128 79.9 20.1
Tigecycline 0.25 0.5  ≤ 0.015–4 96.3 3.7
Europe, ESBL-negative (N = 2373)      
Ceftazidime-avibactam 0.12 0.25  ≤ 0.015– ≥ 256 99.5 0.5
Ceftazidime 0.25 1 0.03– ≥ 256 91.0 2.4 6.7
Cefepime  ≤ 0.12 1  ≤ 0.12– ≥ 64 91.1 4.3 4.6
Ampicillin  ≥ 64  ≥ 64  ≤ 0.5– ≥ 64 16.0 84.0
Amoxicillin-clavulanate 16 32  ≤ 0.12– ≥ 64 47.8 52.2
Piperacillin-tazobactam 2 64  ≤ 0.12– ≥ 256 79.6 5.1 15.3
Aztreonam 0.12 1  ≤ 0.015– ≥ 256 91.4 2.6 6.0
Imipenem 0.12 0.25  ≤ 0.03– ≥ 16 98.7 0.5 0.8
Meropenem 0.03 0.06  ≤ 0.004– ≥ 32 99.2 0.4 0.4
Colistinb (N = 1786) 0.25 1  ≤ 0.06– ≥ 16 98.9 1.1
Amikacin 2 8 0.5– ≥ 128 95.0 5.0
Tigecycline 0.25 0.5  ≤ 0.015–4 94.1 5.9
Latin America, ESBL-positive (N = 1567)     
Ceftazidime-avibactam 0.12 0.5  ≤ 0.015– ≥ 256 99.7 0.3
Ceftazidimea 32 128 0.5– ≥ 256 4.3 10.7 84.9
Cefepimea 32 32  ≤ 0.12– ≥ 64 2.3 6.6 91.1
Ampicillin  ≥ 64  ≥ 64 8– ≥ 64 0.1 99.9
Amoxicillin-clavulanatea 16 32  ≤ 0.12– ≥ 64 25.3 74.7
Piperacillin-tazobactam 8 64  ≤ 0.25– ≥ 256 63.8 17.7 18.5
Aztreonama 64 128 0.5– ≥ 256 0.1 6.4 93.5
Imipenem 0.12 0.25 0.06– ≥ 16 99.2 0.4 0.4
Meropenem 0.03 0.06 0.015– ≥ 32 99.0 0.6 0.4
Colistinb (N = 1232) 0.25 1  ≤ 0.06–8 99.1 0.9
Amikacin 4 16 0.5– ≥ 128 82.6 17.4
Tigecycline 0.25 0.5  ≤ 0.015–4 95.8 4.2
Latin America, ESBL-negative (N = 1132)     
Ceftazidime-avibactam 0.12 0.25  ≤ 0.015–4 100 0.0
Ceftazidime 0.25 1 0.03– ≥ 256 91.1 1.7 7.2
Cefepime  ≤ 0.12 1  ≤ 0.12– ≥ 64 93.3 3.1 3.6
Ampicillin  ≥ 64  ≥ 64 1– ≥ 64 22.0 78.0
Amoxicillin-clavulanate 8 32  ≤ 0.12– ≥ 64 56.0 44.0
Piperacillin-tazobactam 2 32 0.25– ≥ 256 84.9 4.4 10.7
Aztreonam 0.12 1  ≤ 0.015– ≥ 256 90.5 1.9 7.6
Imipenem 0.12 0.25  ≤ 0.03– ≥ 16 99.5 0.1 0.4
Meropenem 0.03 0.06 0.008– ≥ 32 99.4 0.4 0.3
Colistinb (N = 885) 0.25 1  ≤ 0.06– ≥ 16 99.1 0.9
Amikacin 2 8  ≤ 0.25– ≥ 128 94.4 5.6
Tigecycline 0.25 0.5  ≤ 0.015–4 95.5 4.5
  1. – Indicates no breakpoint for the agent
  2. ESBL, extended-spectrum β-lactamase; %I, percentage of isolates susceptible, increased exposure; MIC, minimum inhibitory concentration; MIC50, MIC required to inhibit growth of 50% of isolates (mg/L); MIC90, MIC required to inhibit growth of 90% of isolates (mg/L); %R, percentage of isolates resistant; %S, percentage of isolates susceptible, standard dosing
  3. aNot suitable for use in the treatment of infections caused by ESBL-positive isolates
  4. bColistin was included on the comparator panel from 2014 onwards