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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

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