What is it about?
Aztreonam is not hydrolyzed by MBLs. However, since many MBLproducing strains co-produce enzymes that could hydrolyze aztreonam (e.g., AmpC, ESBL), a robust beta -lactamase inhibitor such as avibactam could be given as a partner drug. Aztreonam retains a high activity (MIC 4 mg/L when combined with avibactam) in 80% of MBL-producing Enterobacterales, 85% of Stenotrophomonas and 6% of MBL-producing Pseudomonas. Clinical resolution within 30 days was reported in 80% of infected patients.
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Why is it important?
The combination aztreonam + avibactam appears to be a promising option against MBL-producing bacteria (especially Enterobacterales, much less for Pseudomonas).
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This page is a summary of: The Revival of Aztreonam in Combination with Avibactam against Metallo-β-Lactamase-Producing Gram-Negatives: A Systematic Review of In Vitro Studies and Clinical Cases, Antibiotics, August 2021, MDPI AG,
DOI: 10.3390/antibiotics10081012.
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