A carbapenem-resistant Klebsiella pneumoniae isolate produces KPC (Klebsiella pneumoniae carbapenemase), a class A serine beta-lactamase. Which newer beta-lactam/beta-lactamase inhibitor combination would be MOST effective against this organism?
- A Piperacillin-tazobactam
- B Ceftazidime-avibactam ✓
- C Imipenem-cilastatin
- D Meropenem-vaborbactam only targets MBLs
Correct answer: B. Ceftazidime-avibactam
Explanation
Avibactam is a novel non-beta-lactam beta-lactamase inhibitor that inhibits class A (including KPC), class C (AmpC), and some class D (OXA-48) serine beta-lactamases. Ceftazidime-avibactam is approved for carbapenem-resistant Enterobacterales producing KPC. Tazobactam (in piperacillin-tazobactam) does not inhibit KPC. Imipenem itself is hydrolyzed by KPC. Meropenem-vaborbactam also covers KPC (vaborbactam is a boronic acid-based inhibitor targeting class A/C), but ceftazidime-avibactam is more commonly referenced for KPC in current guidelines.
Reference: KD Tripathi, Essentials of Medical Pharmacology, 8th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.