Treatment of severe infections due to metallo-β-lactamases-producing Gram-negative bacteria. 2020

Matteo Bassetti, and Vincenzo Di Pilato, and Tommaso Giani, and Antonio Vena, and Gian Maria Rossolini, and Anna Marchese, and Daniele R Giacobbe
Infectious Diseases Unit, Ospedale Policlinico San Martino - IRCCS, Genoa, Italy.

In the last decades, there was an important paucity of agents for adequately treating infections due to metallo-β-lactamases-producing Gram-negative bacteria (MBL-GNB). Cefiderocol, a novel siderophore cephalosporin showing in vitro activity against MBL-GNB, has been recently marketed, and a combination of aztreonam and ceftazidime/avibactam has shown a possible favorable effect on survival of patients with severe MBL-GNB infections in observational studies. Other agents showing in vitro activity against MBL-GNB are currently in clinical development (e.g., cefepime/taniborbactam, LYS228, cefepime/zidebactam) that could be an important addition to our future armamentarium for severe MBL-GNB infections. Nonetheless, we should not discontinue our efforts to optimize the use of non-β-lactams agents, since they could remain an essential last-resort or alternative option in selected cases.

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