New β-Lactam-β-Lactamase Inhibitor Combinations
| Autor: | Henrietta Abodakpi, Christian G. Giske, Alise Grāmatniece, Vincent H. Tam, Leonard Leibovici, Dafna Yahav |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Microbiology (medical)
Drug Imipenem Bacilli Epidemiology Klebsiella pneumoniae media_common.quotation_subject Microbial Sensitivity Tests medicine.disease_cause beta-Lactams Meropenem Microbiology Drug Resistance Multiple Bacterial Gram-Negative Bacteria polycyclic compounds medicine media_common General Immunology and Microbiology biology Pseudomonas aeruginosa business.industry Public Health Environmental and Occupational Health biochemical phenomena metabolism and nutrition bacterial infections and mycoses biology.organism_classification Ceftazidime/avibactam Acinetobacter baumannii Drug Combinations Infectious Diseases bacteria Erratum business beta-Lactamase Inhibitors medicine.drug |
| Zdroj: | Clin Microbiol Rev |
| ISSN: | 1098-6618 |
| Popis: | The limited armamentarium against drug-resistant Gram-negative bacilli has led to the development of several novel β-lactam-β-lactamase inhibitor combinations (BLBLIs). In this review, we summarize their spectrum of in vitro activities, mechanisms of resistance, and pharmacokinetic-pharmacodynamic (PK-PD) characteristics. A summary of available clinical data is provided per drug. Four approved BLBLIs are discussed in detail. All are options for treating multidrug-resistant (MDR) Enterobacterales and Pseudomonas aeruginosa Ceftazidime-avibactam is a potential drug for treating Enterobacterales producing extended-spectrum β-lactamase (ESBL), Klebsiella pneumoniae carbapenemase (KPC), AmpC, and some class D β-lactamases (OXA-48) in addition to carbapenem-resistant Pseudomonas aeruginosa Ceftolozane-tazobactam is a treatment option mainly for carbapenem-resistant P. aeruginosa (non-carbapenemase producing), with some activity against ESBL-producing Enterobacterales Meropenem-vaborbactam has emerged as treatment option for Enterobacterales producing ESBL, KPC, or AmpC, with similar activity as meropenem against P. aeruginosa Imipenem-relebactam has documented activity against Enterobacterales producing ESBL, KPC, and AmpC, with the combination having some additional activity against P. aeruginosa relative to imipenem. None of these drugs present in vitro activity against Enterobacterales or P. aeruginosa producing metallo-β-lactamase (MBL) or against carbapenemase-producing Acinetobacter baumannii Clinical data regarding the use of these drugs to treat MDR bacteria are limited and rely mostly on nonrandomized studies. An overview on eight BLBLIs in development is also provided. These drugs provide various levels of in vitro coverage of carbapenem-resistant Enterobacterales, with several drugs presenting in vitro activity against MBLs (cefepime-zidebactam, aztreonam-avibactam, meropenem-nacubactam, and cefepime-taniborbactam). Among these drugs, some also present in vitro activity against carbapenem-resistant P. aeruginosa (cefepime-zidebactam and cefepime-taniborbactam) and A. baumannii (cefepime-zidebactam and sulbactam-durlobactam). |
| Databáze: | OpenAIRE |
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