The Battle Is on: New Beta-Lactams for the Treatment of Multidrug-Resistant Gram-Negative Organisms

AbstractPurpose of ReviewResistant gram-negative infections are becoming increasingly difficult to treat, prompting increased focus on drug development. This review will focus primarily on the new beta-lactam agents developed in the past 5  years that target multidrug-resistant (MDR) gram-negative organisms, including those producing carbapenemases.Recent FindingsFour new agents including ceftazidime-avibactam (CAZ-AVI), meropenem-vaborbactam (MER-VAB), imipenem-relebactam (IMI-REL), and cefiderocol have recently been approved for the treatment of resistant gram-negative infections. CAZ-AVI remains an option forblaOXA-48 –producing isolates and potentially MDRPseudomonas aeruginosa, but the concern for resistance arises when using the agent for KPC-producingEnterobacteriales. MER-VAB appears to be more stable than CAZ-AVI in the treatment of KPC-producingEnterobacteriales but less is known about its propensity for the development of resistance and the drug does not reliably expand the coverage of meropenem-resistantP.aeruginosa isolates. IMI-REL expands the spectrum of imipenem-cilastatin to include KPC-producingEnterobacteriales as well as MDRP.aeruginosa but much less is known about its real-world clinical utility. Cefiderocol is the only of the four new agents with efficacy against metallo-beta-lactamases and resistantAcinetobacter species, but comparator studies using best available therapy for carbapenem-resistant gram-negative bacterial infections show higher mortali...
Source: Current Infectious Disease Reports - Category: Infectious Diseases Source Type: research