Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases [Clin Microbiol Infect] 2025 Jun; Vol. 31 (6), pp. 971-978. Date of Electronic Publication: 2024 Nov 09.

Publisher: Elsevier Country of Publication: England NLM ID: 9516420 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1469-0691 (Electronic) Linking ISSN: 1198743X NLM ISO Abbreviation: Clin Microbiol Infect Subsets: MEDLINE

Azabicyclo Compounds*/therapeutic use , Azabicyclo Compounds*/pharmacology , Aztreonam*/therapeutic use , Aztreonam*/pharmacology , beta-Lactamases*/metabolism , Gram-Negative Bacteria*/drug effects , Gram-Negative Bacteria*/enzymology , Gram-Negative Bacterial Infections*/drug therapy , Gram-Negative Bacterial Infections*/microbiology , Anti-Bacterial Agents*/therapeutic use , Anti-Bacterial Agents*/pharmacology , beta-Lactamase Inhibitors*/therapeutic use , beta-Lactamase Inhibitors*/pharmacology, Humans ; Drug Therapy, Combination ; Drug Combinations ; Microbial Sensitivity Tests

Background: Carbapenem-resistant gram-negative bacteria represent a challenging healthcare threat, accounting for metallo-β-lactamases (MBL) production increase across the world. MBL-producing Enterobacterales and Pseudomonas aeruginosa represent the main target for ultimate antibiotics combinations due to the difficulty to include carbapenems within the antimicrobial treatment.
Objectives: To provide a comprehensive review of the current knowledge about the aztreonam/avibactam (ATM-AVI) combination, which has emerged as a promising option for treating MBL-producing bacteria.
Sources: Relevant in vitro and in vivo studies on ATM-AVI effectiveness.
Content: The review summarizes ATM-AVI characteristics and targets, examining how AVI restores ATM effectiveness against MBLs while protecting it from other β-lactamases. Key in vitro and in vivo studies on ATM-AVI efficacy are presented.
Implications: This review provides insights into the potential clinical management implications of ATM-AVI for treating carbapenem-resistant gram-negative infections, particularly those caused by MBL-producing organisms.
(Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)