Examining Aztreonam-Avibactam for Gram-Negative Infections

A novel pairing of aztreonam and avibactam offers a long-needed solution to combat highly drug-resistant gram-negative bacteria, particularly those producing difficult-to-treat metallo-β-lactamases.

Joshua Rosenberg, MD, discuses the differences in clinical trials that enroll both intra-abdominal infection patients and those with hospital- or ventilator-associated pneumonia face major complexity because these two groups differ widely in baseline severity, mortality risk, and expected treatment outcomes

Joshua Rosenberg, MD, continues the discussion on the REVISIT study, which showed comparable—or lower—28-day mortality rates than meropenem/colistin despite treating a higher proportion of patients with metallo-β-lactamase–producing pathogens.

Aztreonam-avibactam achieved noninferior clinical cure rates and a comparable safety profile to meropenem/colistin, even amid a high proportion of carbapenemase-producing pathogens.

Clinicians should view the open-label data as promising but preliminary, with post-marketing evidence expected to play a critical role in defining its place in guidelines for treating MBL-producing, multidrug-resistant infections.

Early international experience and evolving real-world data indicate that the new MBL-targeting regimen shows strong potential for US clinicians, despite expected resistance patterns and still-developing evidence.