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Treatment of severe infections due to metallo-β-lactamases-producing Gram-negative bacteria

Matteo Bassetti1,2, Vincenzo Di Pilato3, Tommaso Giani4,5

  • 1Infectious Diseases Unit, Ospedale Policlinico San Martino - IRCCS, Genoa, Italy.

Future Microbiology
|November 3, 2020
PubMed

Insights

New antibiotics like cefiderocol and combinations such as aztreonam/ceftazidime-avibactam offer hope for treating metallo-β-lactamases-producing Gram-negative bacteria (MBL-GNB) infections. Ongoing research into other agents and non-β-lactams is crucial for future treatment options.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Pharmacology

Background:

  • Metallo-β-lactamases-producing Gram-negative bacteria (MBL-GNB) infections pose a significant treatment challenge due to limited therapeutic options.
  • There has been a historical scarcity of effective antimicrobial agents against MBL-GNB.

Purpose of the Study:

  • To review current and emerging therapeutic strategies for infections caused by metallo-β-lactamases-producing Gram-negative bacteria.
  • To highlight the role of novel agents and combinations in combating MBL-GNB infections.

Main Methods:

  • Review of existing literature on antimicrobial agents targeting MBL-GNB.
  • Analysis of *in vitro* activity data for novel antibiotics and combinations.
  • Discussion of clinical development status and potential applications of new agents.

Main Results:

  • Cefiderocol, a novel siderophore cephalosporin, demonstrates *in vitro* activity against MBL-GNB.
  • Combinations like aztreonam and ceftazidime/avibactam show potential benefits in severe MBL-GNB infections.
  • Several agents, including cefepime/taniborbactam and cefepime/zidebactam, are in clinical development.

Conclusions:

  • Cefiderocol and emerging agents represent promising additions to the treatment of MBL-GNB infections.
  • Optimizing the use of non-β-lactam agents remains important as a last-resort or alternative therapy.
  • Continued research and development are essential to expand the armamentarium against these challenging pathogens.
Keywords:
IMPNDMVIMavibactamaztreonamcefiderocol

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