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Aztreonam-avibactam for the treatment of intra-abdominal infections

Hannah Delp1, Gabrielle A Gibson1, Sara A Buckman2

  • 1Pharmacy Department, Barnes-Jewish Hospital Plaza, St Louis, MO, USA.

Expert Opinion on Pharmacotherapy
|September 27, 2024
PubMed
Abstract

Insights

Aztreonam/avibactam (ATM-AVI) offers a new treatment for complicated intra-abdominal infections. This combination antibiotic effectively combats resistant gram-negative organisms, addressing a critical unmet need in patient care.

Area of Science:

  • Infectious Diseases
  • Pharmacology
  • Microbiology

Background:

  • Intra-abdominal infections (IAIs) are increasingly prevalent, associated with significant morbidity and mortality.
  • Rising incidence of IAIs caused by antibiotic-resistant gram-negative organisms poses a therapeutic challenge.
  • Limited treatment options exist for IAIs caused by resistant gram-negative pathogens, particularly those with metallo-β-lactamases.

Purpose of the Study:

  • To evaluate aztreonam/avibactam (ATM-AVI) as a novel therapeutic option for complicated intra-abdominal infections.
  • To review the chemistry, pharmacodynamics, pharmacokinetics, and clinical data of ATM-AVI.
  • To discuss the role of ATM-AVI in managing infections caused by resistant gram-negative bacteria.

Main Methods:

  • Drug evaluation manuscript synthesizing existing data.
  • Review of antimicrobial agents for IAIs.
  • Analysis of clinical studies on ATM-AVI.

Main Results:

  • Aztreonam/avibactam (ATM-AVI) is a combination of aztreonam and avibactam, a broad-spectrum β-lactamase inhibitor.
  • ATM-AVI, in combination with metronidazole, is approved in Europe for complicated IAIs.
  • Demonstrated safety and efficacy for empiric treatment and targeted therapy against resistant gram-negative organisms.

Conclusions:

  • ATM-AVI represents a valuable addition to the therapeutic armamentarium against complicated IAIs.
  • It provides a crucial option for infections involving difficult-to-treat resistant gram-negative bacteria.
  • Recommended for empiric use in high-incidence areas and for culture-confirmed resistant infections.
Keywords:
Antibiotic resistanceMultidrug resistant gram-negative bacteriaaztreonam-avibactamcomplicated intra-abdominal infectionsβ-lactam-β-lactamase inhibitors

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