Movatterモバイル変換

[0]ホーム
URL:

Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
Thehttps:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

NIH NLM Logo
Log inShow account info
Access keysNCBI HomepageMyNCBI HomepageMain ContentMain Navigation
pubmed logo
Advanced Clipboard
User Guide

Full text links

MDPI full text link MDPI Free PMC article
Full text links

Actions

Share

Review
.2021 Aug 20;10(8):1012.
doi: 10.3390/antibiotics10081012.

The Revival of Aztreonam in Combination with Avibactam against Metallo-β-Lactamase-Producing Gram-Negatives: A Systematic Review of In Vitro Studies and Clinical Cases

Affiliations
Review

The Revival of Aztreonam in Combination with Avibactam against Metallo-β-Lactamase-Producing Gram-Negatives: A Systematic Review of In Vitro Studies and Clinical Cases

Carola Mauri et al. Antibiotics (Basel)..

Abstract

Infections caused by metallo-β-lactamase (MBL)-producingEnterobacterales andPseudomonas are increasingly reported worldwide and are usually associated with high mortality rates (>30%). Neither standard therapy nor consensus for the management of these infections exist. Aztreonam, an old β-lactam antibiotic, is not hydrolyzed by MBLs. However, since many MBL-producing strains co-produce enzymes that could hydrolyze aztreonam (e.g., AmpC, ESBL), a robust β-lactamase inhibitor such as avibactam could be given as a partner drug. We performed a systematic review including 35 in vitro and 18 in vivo studies on the combination aztreonam + avibactam for infections sustained by MBL-producing Gram-negatives. In vitro data on 2209 Gram-negatives were available, showing the high antimicrobial activity of aztreonam (MIC ≤ 4 mg/L when combined with avibactam) in 80% of MBL-producingEnterobacterales, 85% ofStenotrophomonas and 6% of MBL-producingPseudomonas. Clinical data were available for 94 patients: 83% of them had bloodstream infections. Clinical resolution within 30 days was reported in 80% of infected patients. Analyzing only patients with bloodstream infections (64 patients), death occurred in 19% of patients treated with aztreonam + ceftazidime/avibactam. The combination aztreonam + avibactam appears to be a promising option against MBL-producing bacteria (especiallyEnterobacterales, much less forPseudomonas) while waiting for new antimicrobials.

Keywords: Enterobacterales; Pseudomonas; Stenotrophomonas; antibiotic combination; avibactam; aztreonam; ceftazidime/avibactam; last resource antibiotic; metallo-β-lactamase; old antibiotic.

PubMed Disclaimer

Conflict of interest statement

All the authors declare no conflict of interest.

Figures

Figure 1
Figure 1
β-lactam antibiotic targets of MBL enzymatic activity.
Figure 2
Figure 2
Literature search strategy.
Figure 3
Figure 3
Forest plot of the 30-day mortality odds ratio between CZA plus ATM and other regimens against infections by MBL-producing strains. ATM, aztreonam; CZA, ceftazidime/avibactam; OAA, other active agent.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Tan X., Kim H.S., Baugh K., Huang Y., Kadiyala N., Wences M., Singh N., Wenzler E., Bulman Z.P. Therapeutic Options for Metallo-β-Lactamase-Producing Enterobacterales. Infect. Drug Resist. 2021;14:125–142. doi: 10.2147/IDR.S246174. - DOI - PMC - PubMed
    1. Khan A.U., Maryam L., Zarrilli R. Structure, genetics and worldwide spread of New Delhi metallo-β-lactamase (NDM): A threat to public health. BMC Microbiol. 2017;17:101–112. doi: 10.1186/s12866-017-1012-8. - DOI - PMC - PubMed
    1. Snyder B.M., Montague B.T., Anandan S., Madabhushi A.G., Pragasam A.K., Verghese V.P., Balaji V., Simões E.A.F. Risk factors and epidemiologic predictors of bloodstream infections with New Delhi metallo-β-lactamase (NDM-1) producing Enterobacteriaceae. Epidemiol. Infect. 2019;147:1–9. doi: 10.1017/S0950268819000256. - DOI - PMC - PubMed
    1. Falcone M., Tiseo G., Antonelli A., Giordano C., Di Pilato V., Bertolucci P., Parisio E.M., Leonildi A., Aiezza N., Baccani I., et al. Clinical features and outcomes of bloodstream infections caused by New Delhi metallo-β-lactamase-producing Enterobacterales during a regional outbreak. Open Forum Infect. Dis. 2020;7:1–5. doi: 10.1093/ofid/ofaa011. - DOI - PMC - PubMed
    1. Spyropoulou A., Bartzavali C., Vamvakopoulou S., Marangos M., Anastassiou E.D., Spiliopoulou I., Christofidou M. The first NDM metallo-β-lactamase producing Klebsiella pneumoniae isolate in a university hospital of southwestern Greece. J. Chemother. 2016;28:350–351. doi: 10.1179/1973947815Y.0000000003. - DOI - PubMed

Publication types

LinkOut - more resources

Full text links
MDPI full text link MDPI Free PMC article
Cite
Send To

NCBI Literature Resources

MeSHPMCBookshelfDisclaimer

The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Unauthorized use of these marks is strictly prohibited.

[8]ページ先頭
©2009-2025 Movatter.jp