Emblaveo (aztreonam/avibactam) / Pfizer, AstraZeneca, AbbVie - LARVOL DELTA

New β-Lactam/β-Lactamase Inhibitor Combination Antibiotics. (PubMed, Pathogens) - "During the last 2 years from the writing of this article, cefepime/enmetazobactam, aztreonam/avibactam, and sulbactam/durlobactam were approved for use in clinical practice. Aztreonam/avibactam is indicated for the treatment of adult patients who suffer from complicated intra-abdominal infections, complicated urinary tract infections including pyelonephritis, hospital-acquired pneumonia, and ventilator-associated pneumonia due to aerobic Gram-negative infections with limited therapeutic options. Sulbactam/durlobactam, a combination of 2 β-lactamase inhibitors, is indicated for the treatment of adult patients with hospital-acquired bacterial pneumonia and ventilator-associated bacterial pneumonia due to the Acinetobacter baumannii-calcoaceticus complex [including carbapenem-resistant Acinetobacter baumannii (CRAB) infections]."

Journal • Review • Infectious Disease • Nephrology • Pneumonia • Respiratory Diseases

l-2,3-Diaminopropionate Binding Mode of the SulM Adenylation Domain Limits Engineering Monobactam Analogue Biosynthesis with Larger Substrates. (PubMed, JACS Au) - "The recent FDA approval of Emblaveo to treat serious bacterial infections combines an established synthetic monobactam aztreonam and avibactam, which additionally blocks serine β-lactamases, to create a broadly effective antibacterial therapeutic. Comparisons with the structures of other diamino acid-activating adenylation domains identify alternate binding modes that may be more suitable for the production of sulfazecin analogues. The impact of these structures on the further engineering of the SulA3 domain and its relation to monobactam synthesis in the recently structurally characterized SulTE are discussed."

Journal • Infectious Disease

Characterization of Enterobacter cloacae and Citrobacter freundii Species Complex Isolates with Decreased Susceptibility to Cephalosporins from United States Hospitals and Activity of Aztreonam-Avibactam and Comparator Agents (2019-2023). (PubMed, Antibiotics (Basel)) - "Aztreonam-avibactam was highly active against cephalosporin-nonsusceptible ECLC and CFC, including MBL producers. The activities of ceftazidime-avibactam, meropenem-vaborbactam, and cefiderocol were compromised against CB-R isolates due to the high frequency of NDM producers."

Journal • Infectious Disease

Estimating the Magnitude of a Pull Incentive for Antibiotic Development Using the STEDI Value Framework: An Example From Spain (ISPOR 2025) - "Using only transmission and diversity elements of the STEDI framework, this analysis shows that a novel antibiotic (ATM-AVI) provides substantial value to the Spanish healthcare system. Unlocking the value of novel antimicrobials in the context of existing antimicrobial resistance supports policy decisions that incentivize novel antimicrobial development."

Infectious Disease • Nephrology • Pneumonia • Respiratory Diseases

Analysis of intrahospital and global dissemination and resistome dynamics of NDM-1-producing ST773 Pseudomonas aeruginosa high-risk clone. (PubMed, JAC Antimicrob Resist) - "Lastly, HCB isolates evolved further resistome mutations during intrahospital dissemination, including regulators of AmpC (mpl) and MexAB-OprM (nalD), linked to the acquisition of aztreonam/avibactam resistance, and thus remaining only susceptible to cefiderocol and colistin. This work evidences the transborder spread and intrahospital dissemination and evolution of the emerging ST773-NDM-1 P. aeruginosa high-risk clone."

Journal • Breast Cancer • Oncology • Solid Tumor

Genomic analysis of carbapenemase-encoding plasmids and antibiotic resistance in carbapenem-resistant Klebsiella pneumoniae isolates from Vietnam, 2021. (PubMed, Microbiol Spectr) - "Despite their resistance to many antibiotics, most strains remained susceptible to newer substances like cefiderocol and aztreonam/avibactam. This research provides insight into the epidemiology of the carbapenemase gene-harboring plasmids in a Vietnamese hospital. Understanding these resistance patterns can help guide antibiotic use and policy decisions to combat the growing threat of multidrug-resistant infections in Vietnam."

Journal • Critical care • Infectious Disease • Pneumonia

Diagnostic algorithm for the detection of carbapenemases and extended-spectrum β-lactamases in carbapenem-resistant Pseudomonas aeruginosa. (PubMed, Microbiol Spectr) - "We used the following BL-BLI combinations: ceftolozane-tazobactam (C-T), ceftazidime-avibactam, imipenem-relebactam (I-R), meropenem-vaborbactam, cefepime-enmetazobactam (C-E), and aztreonam-avibactam. This method is particularly valuable for laboratories lacking access to molecular diagnostics, as it provides a practical alternative for routine testing. By facilitating the early detection of resistant P. aeruginosa strains, this approach has the potential to improve patient outcomes, optimize antimicrobial therapy, and enhance global surveillance efforts against multidrug-resistant pathogens."

Journal • Infectious Disease

CEFTAZIDIME-AVIBACTAM PLUS AZTREONAM IN MANAGING MULTIDRUG-RESISTANT GRAM-NEGATIVE INFECTIONS IN PAEDIATRICS: A SINGLE-CENTRE CASE SERIES. (ESPID 2025) - "Background Aztreonam-avibactam targets multidrug-resistant (MDR) Gram-negative pathogens, including those producing metallo-β-lactamases (MBL). Combination of aztreonam-avibactam has recently been licensed to use in adults and may soon be available in children. Larger trials are needed to establish its efficacy and place in paediatric guidelines."

Clinical • Gram negative • Cognitive Disorders • Infectious Disease • Pediatrics

Frequency, Antimicrobial Susceptibility, and Molecular Characterization of Carbapenem-Resistant Enterobacterales Stratified by United States Census Divisions: Results From the INFORM Program (2018-2022). (PubMed, Open Forum Infect Dis) - "Recently approved β-lactamase inhibitor combinations, such as ceftazidime-avibactam, meropenem-vaborbactam, and imipenem-relebactam, have demonstrated a broad spectrum of activity against carbapenem-resistant Enterobacterales (CRE) from US hospitals, but resistance may emerge with the increasing use of these compounds. Aztreonam-avibactam showed potent activity against CRE, including MBL producers. Resistance to ceftazidime-avibactam and meropenem-vaborbactam was observed among CRE because of increasing occurrence of MBL-producing isolates."

Journal • Infectious Disease • Pneumonia

Carbapenem-resistant Klebsiella pneumoniae infections in Chinese children: in vitro activities of ceftazidime-avibactam and aztreonam-avibactam against carbapenemase-producing strains in a two-center study. (PubMed, Front Cell Infect Microbiol) - "The sensitivity rates of KPC-KP to CZA and NDM-KP to AZA were 100%, and the MIC50 of the CRKP to CZA and AZA were 2 μg/mL and 0.125μg/mL, respectively. The epidemiological characteristics of Chinese children with CRKP infections, including the resistance genes and the antibiotic resistance of CRKP, exhibited significant variation between the two regions.KPC-KP strains had higher antimicrobial resistance in patients and thus should be given more attention in clinics and infection control."

Journal • Preclinical • Critical care • Infectious Disease • Pediatrics • Pneumonia

Geographic variations in distributions of carbapenemase-encoding genes, susceptibilities, and minimum inhibitory concentrations of inpatient meropenem-resistant Enterobacterales to ceftazidime-avibactam, meropenem-vaborbactam, and aztreonam-avibactam across four global regions: 2020-2022 Data from the Antimicrobial Testing Leadership and Surveillance. (PubMed, Int J Antimicrob Agents) - "The MIC50/90 values of CPE isolates to ATM-AVI were 0.12/0.25 mg/L and 0.5/1 mg/L, respectively, regardless of collection region, dual carbapenemase production, or infection source. These trends in resistance to novel antibiotics among contemporary CPE isolates need close monitoring."

Journal • Infectious Disease • Pneumonia

Newly developed antibiotics against multidrug-resistant and carbapenem-resistant Gram-negative bacteria: action and resistance mechanisms. (PubMed, Arch Microbiol) - "Porin modifications reduce the influx of antibiotics, whereas overexpression of efflux pumps, particularly those in the resistance-nodulation-cell division (RND) family, actively expels antibiotics from bacterial cells, significantly lowering intracellular drug concentrations and leading to treatment failure.This review examines the mechanisms of action, resistance profiles, and pharmacokinetic/pharmacodynamic characteristics of newly developed antibiotics designed to combat infections caused by MDR and carbapenem-resistant Gram-negative pathogens. The antibiotics discussed include ceftazidime-avibactam, imipenem-relebactam, ceftolozane-tazobactam, meropenem-vaborbactam, aztreonam-avibactam, delafloxacin, temocillin, plazomicin, cefiderocol, and eravacycline."

Journal • Review • Critical care • Infectious Disease

Spectrum of cefepime-taniborbactam coverage against 190 β-lactamases defined in engineered isogenic Escherichia coli strains. (PubMed, Antimicrob Agents Chemother) - "Among the 129 β-lactamase-overproducing strains with increased cefepime MIC ≥16-fold relative to the control strain, taniborbactam potentiated cefepime MIC by ≥8-fold for 113 strains overexpressing β-lactamases (42 Ambler class A, 24 B, 23 C, and 24 D). Cefepime-taniborbactam demonstrated broader activity relative to ceftazidime-avibactam and comparable activity with aztreonam-avibactam in the overall coverage of both serine- and metallo-β-lactamases from all four Ambler classes."

Journal • Infectious Disease

Emerging resistance mechanisms to newer β-lactams in Pseudomonas aeruginosa. (PubMed, Clin Microbiol Infect) - "A deep understanding of emerging resistance mechanisms, including their conferred cross resistances and collateral susceptibilities, should be useful for the optimization of treatments of severe XDR/DTR P. aeruginosa infections."

Journal • Review • Infectious Disease

Geographic variations in distributions of carbapenemase-encoding genes, susceptibilities, and minimum inhibitory concentrations of inpatient meropenem-resistant Enterobacterales to ceftazidime/avibactam, meropenem/vaborbactam, and aztreonam/avibactam across four global regions: 2020-2022 data from the antimicrobial testing leadership and surveillance (ESCMID Global 2025) - No abstract available

Clinical

Genetic background of aztreonam-avibactam resistant Enterobacterales in Germany (ESCMID Global 2025) - No abstract available

Late-breaking abstract

Feasibility assessment for indirect treatment comparisons (ITC) of aztreonam-avibactam (ATM-AVI) vs comparators for treating serious infections caused by Enterobacterales, including metallo-beta-lactamase (MBL)-producing pathogens (ESCMID Global 2025) - No abstract available

Infectious Disease

Using the STEDI AMR value framework to estimate the clinical and economic value of aztreonam/avibactam in treating metallo-beta-lactamase-producing Enterobacterales infections in Spain (ESCMID Global 2025) - No abstract available

Clinical • Infectious Disease

Efficacy of aztreonam/avibactam, ceftazidime-avibactam, and cefiderocol against multidrug-resistant and putative-hypervirulent Klebsiella pneumoniae isolates (ESCMID Global 2025) - No abstract available

Clinical • Infectious Disease • Pneumonia

Clinical, microbiological, and pharmacokinetic/pharmacodynamic (PK/PD) target attainment analyses to support EUCAST aztreonam/avibactam minimum inhibitory concentration (MIC) breakpoints against Enterobacterales (ESCMID Global 2025) - No abstract available

Clinical • PK/PD data

Aztreonam/avibactam is more sparing to the gut microbiome than ceftazidime/avibactam with aztreonam in a human in vitro gut model (ESCMID Global 2025) - No abstract available

Preclinical

The in vitro activity of aztreonam-avibactam against Enterobacterales isolates positive for metallo-beta-lactamases or serine-carbapenemases by commonly used in vitro diagnostic kits (ESCMID Global 2025) - No abstract available

Diagnostic kit • Preclinical

Bacteriophage EC10P1 re-sensitises multidrug-resistant Escherichia coli 456 to aztreonam/avibactam (ESCMID Global 2025) - No abstract available

Activity of zidovudine against carbapenemase-producing Enterobacterales, including cefiderocol and aztreonam/avibactam resistant isolates, and characterisation of in vitro selected resistant isolates (ESCMID Global 2025) - No abstract available

Preclinical

Aztreonam/avibactam resistance rates and resistance mechanisms of NDM-carbapenemase-producing-Enterobacterales (CPE) and NDM/OXA48-like-dual-CPE in Singapore (ESCMID Global 2025) - No abstract available