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Review
. 2024 Aug 14;13(8):766.
doi: 10.3390/antibiotics13080766.

Practical Application of Aztreonam-Avibactam as a Treatment Strategy for Ambler Class B Metallo-β-Lactamase Producing Enterobacteriaceae

Darren W Wong  1
Affiliations
Review

Practical Application of Aztreonam-Avibactam as a Treatment Strategy for Ambler Class B Metallo-β-Lactamase Producing Enterobacteriaceae

Darren W Wong. Antibiotics (Basel). .

Abstract

Carbapenem-resistant Enterobacteriaceae infections are a considerable challenge for clinicians. In recent years, novel antibiotic options have resulted in a tremendous advance in medical therapy; however, current treatment options are primarily effective for resistance derived from serine-based carbapenemases. The Ambler class B metallo-β-lactamases (MBLs) remain a critical challenge with decidedly fewer effective options. One intriguing option for these MBL pathogens is the combination of ceftazidime-avibactam with aztreonam. While clinical experience with this regimen is limited, in vitro studies are promising, and limited case reports describe success with this regimen; however, significant challenges preclude widespread adoption of this novel treatment regimen. A systemic literature review was performed to offer recommendations based on current evidence for a practical strategy on how to best integrate the use of aztreonam with avibactam combination therapy.

Keywords: MBL; NDM; aztreonam-avibactam; ceftazidime-avibactam.

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Conflict of interest statement

The author declares no conflicts of interest.

Figures

Figure 1
Figure 1
Literature Review Methodology.
Figure 2
Figure 2
Diagnostic and therapeutic strategy for the selection of patients and use of ceftazidime-avibactam with aztreonam therapy. MBL = metallo-β-lactamase.
See this image and copyright information in PMC

References

    1. Hauck C., Cober E., Richter S.S., Perez F., Salata R.A., Kalayjian R.C., Watkins R.R., Scalera N.M., Doi Y., Kaye K.S., et al. Spectrum of excess mortality due to carbapenem-resistant Klebsiella pneumoniae infections. Clin. Microbiol. Infect. 2016;22:513–519. doi: 10.1016/j.cmi.2016.01.023. - DOI - PMC - PubMed
    1. Gasink L.B., Edelstein P.H., Lautenbach E., Synnestvedt M., Fishman N.O. Risk factors and clinical impact of Klebsiella pneumoniae carbapenemase-producing K. pneumoniae. Infect. Control. Hosp. Epidemiol. 2009;30:1180–1185. doi: 10.1086/648451. - DOI - PMC - PubMed
    1. Wong D., van Duin D. Carbapenemase-producing organisms in solid organ transplantation. Curr. Opin. Organ Transplant. 2019;24:490–496. doi: 10.1097/MOT.0000000000000664. - DOI - PubMed
    1. van Duin D., Arias C.A., Komarow L., Chen L., Hanson B.M., Weston G., Cober E., Garner O.B., Jacob J.T., Satlin M.J., et al. Molecular and clinical epidemiology of carbapenem-resistant Enterobacterales in the USA (CRACKLE-2): A prospective cohort study. Lancet Infect. Dis. 2020;20:731–741. doi: 10.1016/S1473-3099(19)30755-8. - DOI - PMC - PubMed
    1. Tamma P.D., Aitken S.L., Bonomo R.A., Mathers A.J., van Duin D., Clancy C.J. Infectious Diseases Society of America 2022 Guidance on the Treatment of Extended-Spectrum β-lactamase Producing Enterobacterales (ESBL-E), Carbapenem-Resistant Enterobacterales (CRE), and Pseudomonas aeruginosa with Difficult-to-Treat Resistance (DTR-P. aeruginosa) Clin. Infect. Dis. 2022;75:187–212. doi: 10.1093/cid/ciac268. - DOI - PMC - PubMed

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