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Updated: Feb 4, 2026
Isolation and Identification of Waterborne Antibiotic-Resistant Bacteria and Molecular Characterization of their Antibiotic Resistance Genes
Published on: March 3, 2023
[New β‑lactam antibiotics and β‑lactamase inhibitors against multidrug-resistant Gram-negative bacteria]
Alexander Mischnik1, Christoph Lübbert2, Nico T Mutters3
1Klinik für Infektiologie und Mikrobiologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Deutschland. alexander.mischnik@uksh.de.
Background:
The worldwide spread of multidrug-resistant Gram-negative bacteria (MDR-GN) continues. Treatment options for infections caused by MDR-GN remain scarce and only few new substances are currently in clinical phase II/III studies or have already been granted market approval.
Objectives:
To provide an overview about current data on new β‑lactam antibiotics and β‑lactamase inhibitor combinations, respectively. New macrolides, ketolides and aminoglycosides are not addressed.
Materials And Methods:
Selective literature research regarding published data on ceftazidim/avibactam, ceftolozan/tazobactam, imipenem/cilastatin + relebactam, meropenem/vaborbactam, aztreonam/avibactam and cefiderocol, as well as registered trials.
Results:
The development of new antimicrobials for the treatment of MDR-GN infections offers new options for attending physicians. β‑Lactamase producers are inhibited by these new substances, though with varying efficacy; however, there are still no adequate treatment options for metallo-β-lactamase (MBL) producers.
Conclusions:
Clinical data are still indifferent and come from heterogeneous patient collectives. Direct comparisons with established treatment strategies, such as the "last-resort use" of polymyxins are hardly possible. Cases of early development of resistance have already been described. Finally, the importance of toxicity and optimal dosing-in organ failure or organ replacement procedures such as dialysis-remain unclear.
Insights
New antibiotics offer options against multidrug-resistant Gram-negative bacteria (MDR-GN), but challenges remain for metallo-β-lactamase (MBL) producers. Further research is needed on efficacy, toxicity, and dosing for these critical infections.
Area of Science:
- Infectious Diseases
- Pharmacology
- Microbiology
Background:
- The global rise of multidrug-resistant Gram-negative bacteria (MDR-GN) presents a significant public health challenge.
- Limited treatment options are available for MDR-GN infections, with few new drugs in late-stage development or approved.
Purpose of the Study:
- To review current data on novel beta-lactam antibiotics and beta-lactamase inhibitor combinations for treating MDR-GN infections.
- This review excludes new macrolides, ketolides, and aminoglycosides.
Main Methods:
- A selective literature search was conducted on published data and registered trials.
- Key agents reviewed include ceftazidime/avibactam, ceftolozane/tazobactam, imipenem/cilastatin + relebactam, meropenem/vaborbactam, aztreonam/avibactam, and cefiderocol.
Main Results:
- New antimicrobial agents provide additional treatment choices for MDR-GN infections.
- These agents demonstrate efficacy against beta-lactamase-producing bacteria, but effectiveness varies.
- Currently, no adequate treatment options exist for infections caused by metallo-beta-lactamase (MBL) producers.
Conclusions:
- Clinical data are limited and derived from heterogeneous patient groups, making direct comparisons difficult.
- Early resistance development has been observed.
- The optimal use, including toxicity and dosing in organ dysfunction or failure, requires further clarification.
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