Growing International Evidence Suggests Emerging Metallo-β-Lactamase Therapy Could Benefit US Clinicians

As global experience with the new Metallo-β-lactamase (MBL)–targeting therapy continues to expand, early findings from Europe offer important signals for U.S. clinicians evaluating its potential role. Initial data—much of it presented at ESCMID and published across open-access infectious disease journals—suggest that the regimen demonstrates strong activity against MBL-producing pathogens, aligning with prior success observed with ceftazidime-avibactam combined with aztreonam.

Several European analyses, including work by Maestro-Giannis and colleagues in Greece, have modeled the therapy’s potential clinical and economic impact. Using a steady-state value approach, the investigators concluded that earlier access to the agent could have delivered significant benefits—both in terms of outcomes and hospital resource use—had it been available in prior years. Similar modeling efforts across other European health systems are reinforcing the expectation of meaningful clinical value.

While no major safety concerns have emerged to date, international surveillance has documented early resistance mechanisms—an anticipated challenge in treating highly resistant gram-negative infections. Reported cases include mutations in MBL enzymes and alterations in penicillin-binding protein 3, each capable of reducing binding affinity.

For US clinicians, these early signals provide cautious optimism. Although current evidence remains limited to case reports and small series, broader real-world datasets and larger studies are expected soon, promising a clearer picture of how this therapy may shape future treatment algorithms.