Reframing the Treatment Landscape for Carbapenem-Resistant Gram-Negative Infections

Safety and mortality findings from the Game Changer trial suggest cefiderocol remains a viable option for select carbapenem-resistant pathogens, while highlighting the importance of pathogen-specific use—particularly avoiding metallo-β-lactamase–producing Enterobacterales when alternatives exist.

As evidence exposes the limits of cefiderocol against metallo-β-lactamase producers, aztreonam–avibactam emerges as a leading option for severe Gram-negative infections, including bloodstream infections.

New trial data and real-world experience are sharpening how clinicians deploy existing antibiotics against diverse and evolving metallo-β-lactamase producers, while underscoring a persistent unmet need for new therapies.