Defining the Role of Novel β-Lactam Agents That Target Carbapenem-Resistant Gram-Negative Organisms

J Pediatric Infect Dis Soc. 2019 Jul 1;8(3):251-260. doi: 10.1093/jpids/piz002.

Abstract

With the current carbapenem-resistant organism crisis, conventional approaches to optimizing pharmacokinetic-pharmacodynamic parameters are frequently inadequate, and traditional salvage agents (eg, colistin, tigecycline, etc) confer high toxicity and/or have low efficacy. However, several β-lactam agents with activity against carbapenem-resistant organisms were approved recently by the US Food and Drug Administration, and more are anticipated to be approved in the near future. The primary goal of this review is to assist infectious disease practitioners with preferentially selecting 1 agent over another when treating patients infected with a carbapenem-resistant organism. However, resistance to some of these antibiotics has already developed. Antibiotic stewardship programs can ensure that they are reserved for situations in which other options are lacking and are paramount for the survival of these agents.

Keywords: aztreonam-avibactam; cefiderocol; ceftazidime-avibactam; ceftolozane-tazobactam; imipenem-cilastatin–relebactam; meropenem-vaborbactam.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • Anti-Bacterial Agents / therapeutic use*
  • Azabicyclo Compounds / therapeutic use
  • Aztreonam / therapeutic use
  • Boronic Acids / therapeutic use
  • Carbapenems / pharmacology*
  • Cefiderocol
  • Ceftazidime / therapeutic use
  • Cephalosporins / therapeutic use
  • Cilastatin, Imipenem Drug Combination / therapeutic use
  • Drug Combinations
  • Drug Resistance, Multiple, Bacterial / drug effects*
  • Gram-Negative Bacteria / drug effects*
  • Gram-Negative Bacterial Infections / drug therapy
  • Heterocyclic Compounds, 1-Ring / therapeutic use
  • Meropenem / therapeutic use
  • Tazobactam / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Azabicyclo Compounds
  • Boronic Acids
  • Carbapenems
  • Cephalosporins
  • Drug Combinations
  • Heterocyclic Compounds, 1-Ring
  • avibactam, ceftazidime drug combination
  • ceftolozane, tazobactam drug combination
  • meropenem and vaborbactam
  • avibactam
  • Cilastatin, Imipenem Drug Combination
  • Ceftazidime
  • Meropenem
  • Aztreonam
  • Tazobactam
  • relebactam