aztreonam / Generic mfg. - LARVOL DELTA

Higher-order epistasis drives evolutionary unpredictability toward novel antibiotic resistance. (PubMed, bioRxiv) - "Over eight million empirical fitness measurements were obtained under selection pressure with both a native antibiotic substrate (ampicillin) and a novel antibiotic (aztreonam), establishing the largest experimentally determined fitness landscape for antibiotic resistance to date. This integrated experimental and computational framework provides a foundation for predictive evolutionary pharmacology, enabling assessments of newly developed β-lactams or emerging β-lactamase variants for their potential contribution to ESBL evolution. Importantly, incorporating graph-theoretically informed evolutionary constraints can strategically disrupt evolutionary pathways, presenting a viable approach to mitigate the rise of antibiotic resistance."

Journal

Prognosis and Outcome of Carbapenem-Resistant Enterobacterales Bacteremia Managed With Ceftazidime-Avibactam and Aztreonam Combination Therapy in Tawam Hospital, UAE: A Retrospective Study. (PubMed, Cureus) - "By identifying key prognostic factors and reporting high mortality and prolonged hospital stays despite combination therapy, it underscores the urgent need for timely intervention, improved antimicrobial stewardship, and enhanced diagnostic capacity. These findings contribute valuable regional data to the global effort to curb antimicrobial resistance."

Journal • Retrospective data • Critical care

Case Commentary: Overcoming intrinsic resistance-the successful use of aztreonam and avibactam for Stenotrophomonas maltophilia meningitis. (PubMed, Antimicrob Agents Chemother) - "Wong-So and colleagues describe a case of post-neurosurgical Stenotrophomonas maltophilia meningitis successfully managed with ceftazidime-avibactam and aztreonam...Simultaneous peak and trough levels in cerebrospinal fluid (CSF) and plasma demonstrated favorable CSF-to-plasma ratios for both aztreonam and avibactam. This case highlights aztreonam-avibactam as a rational therapeutic strategy for S. maltophilia meningitis."

Journal • CNS Disorders • Infectious Disease

Management of Pseudomonas Urinary Tract Infections (UTIs) in the Context of Extensive Antibiotic Anaphylaxis: A Case-Based Perspective. (PubMed, Cureus) - "This case highlights the clinical challenge of managing Pseudomonas UTIs in patients with limited antibiotic options and underscores aztreonam as a valuable therapeutic alternative in such settings. It also emphasizes the importance of individualized antibiotic oversight in patients with complex allergies."

Journal • Allergy • Dermatology • Immunology • Infectious Disease • Nephrology

Tracing the evolutionary trajectory of the IncP-2 plasmid co-harboring bla IMP-45 and bla VIM-1: an outbreak of Pseudomonas aeruginosa co-producing IMP-45 and VIM-1 carbapenemases in China. (PubMed, Front Cell Infect Microbiol) - "Structural and molecular docking studies explored the PBP3 (P527S) mutation's role in aztreonam resistance...All strains were extensively drug-resistant but sensitive to colistin and cefiderocol...This study reports a clonal outbreak of ST313 P. aeruginosa strains co-producing IMP-45 and VIM-1 carbapenemases in a tertiary hospital. The evolutionary path of the IncP-2 plasmid co-harboring bla IMP-45 and bla VIM-1 was elucidated."

Journal • Gene Therapies • Infectious Disease • Transplantation

First detection of CTX-M-65 ESBL gene in Morocco: Evidence of Transcontinental Transmission Linked to commercial Exchange. (PubMed, Microb Pathog) - "The results alert us about the hygienic state of poultry products and the increasing level of antibacterial resistance, and pose a potential risk that could be caused by the transmission of the antimicrobial resistance to humans through the consumption of food products, leading to a reduction of the available antibiotic treatment options."

Journal

Development SPE-LC-MS/MS method for determination of WHO AWaRe Reserve antibiotics in hospital wastewater. (PubMed, Sci Rep) - "The aim of the study was to develop a method for the determination of the following Reserve antibiotics in hospital wastewater: aztreonam, linezolid, meropenem, tigecycline, vaborbactam, cilastatin, fosfomycin, and ceftazidime. The method was validated and applied to the determination of the selected pharmaceuticals in effluents from 16 hospitals in Poland, with Reserve antibiotics detected in each sample at concentrations ranging from 1.89 ng L- 1 to 22.49 µg L- 1. This is the first country-scale methodological study on Reserve antibiotics in hospital wastewater, emphasizing the need for early environmental monitoring and the potential integration of such strategies into healthcare systems to mitigate the global antimicrobial resistance crisis."

Journal

Management of infection and ocular complications in pediatric SJS/TEN-like acute graft-versus-host disease: a clinical case study and literature review. (PubMed, Front Immunol) - "A patient diagnosed with grade IV skin aGVHD received effective treatment for multidrug-resistant Stenotrophomonas maltophilia using minocycline, aztreonam, and ceftazidime-avibactam. Combination therapy with liposomal amphotericin B and voriconazole was efficacious against mixed fungal infections...Evaluating drug susceptibility and immune status is vital for formulating precise therapies. Early recognition and management of ocular symptoms in SJS/TEN-like aGVHD are essential to prevent irreversible damage."

Journal • Acute Graft versus Host Disease • Bone Marrow Transplantation • Graft versus Host Disease • Immunology • Infectious Disease • Ocular Infections • Pediatrics • Steven-Johnson Syndrome • Transplantation • CD4 • PD-1

Establishing Clinical and Laboratory Standards Institute M45 antimicrobial susceptibility testing methods and breakpoints for Pseudomonas other than Pseudomonas aeruginosa. (PubMed, J Clin Microbiol) - "For aztreonam and trimethoprim-sulfamethoxazole, the modal MICs were elevated, and no BPs were set...Upon review, the CLSI M45 committee proposed tentative MIC and DD BPs for expanded-spectrum cephalosporins (ceftazidime and cefepime), carbapenems (meropenem and imipenem), fluoroquinolones (ciprofloxacin and levofloxacin), and the aminoglycosides (amikacin and tobramycin).IMPORTANCEPseudomonas species other than Pseudomonas aeruginosa (POPA) can cause opportunistic infections which may be difficult to treat due to a variety of antimicrobial resistance mechanisms...Mechanisms of antimicrobial resistance and the modified carbapenem inactivation method to detect carbapenemase production were also evaluated. We present the data used by the volunteers tasked by CLSI to develop POPA breakpoints in the M45 guidelines."

Journal • Infectious Disease

Multidrug-resistant Pseudomonas isolated from water at primary health care centers in Gaza, Palestine: a cross-sectional study. (PubMed, IJID Reg) - "High resistance was observed to imipenem (84%) and piperacillin (84%), followed by aztreonam (31.6%) and gentamicin (28.9%). NDM genes were detected in a subset of isolates. The presence of multidrug-resistant, NDM-producing Pseudomonas in reverse osmosis and municipal water highlights the urgent need for water safety, screening, and infection control in conflict-affected health care settings."

Journal • Observational data • Infectious Disease

Tissue Distribution and Pharmacokinetic Characteristics of Aztreonam Based on Multi-Species PBPK Model. (PubMed, Pharmaceutics) - "The Kp values revealed a high distribution of aztreonam in the kidneys (Kp = 2.0-3.0), which was consistent with its clearance mechanism dominated by renal excretion. The PBPK model developed in this study can be used to predict aztreonam pharmacokinetics across species, elucidating its renal-targeted distribution and providing key theoretical support for the clinical dose optimization of aztreonam, the assessment of target tissue exposure in drug-resistant bacterial infections, and the development of combination therapy strategies."

Journal • PK/PD data • Infectious Disease

Predominant Gram-Positive Etiology May Be Associated with a Lower Mortality Rate but with Higher Antibiotic Resistance in Spontaneous Bacterial Peritonitis: A 7-Year Study in a Tertiary Center in Romania. (PubMed, Life (Basel)) - "A low resistance rate to Tigecycline was noted in all infection types; GPB was susceptible to Linezolid and Vancomycin; and GNB was susceptible to Aztreonam and Colistin. In-hospital mortality was 26.7% (40% for GNB-SBP; 20% for GPB-SBP), similar to culture-negative SBP (21.3%), and higher than in the control group (9%); long-term mortality remained higher. (4) microbial changes to GPB etiology and increasing resistance were noted, but with a lower mortality compared to GNB; higher mortality rates up to 1 year for culture-positive and culture-negative SBP were recorded."

Journal • Infectious Disease

Phenotypic and genotypic characterization of biofilm-producing avian pathogenic Escherichia coli (APEC) isolates from Algerian poultry: associations between antimicrobial resistance and virulence genes. (PubMed, Vet Res Commun) - "While none belonged to the O157 serogroup, all isolates demonstrated concerning resistance profiles, with high rates observed for tetracycline (83.3%), ampicillin (75%), and ciprofloxacin (62.5%)...Moreover, the fimH gene showed a strong positive correlation with resistance to the antibiotic nalidixic acid. Resistance to β-lactam antibiotics (cefotaxime, cefepime, aztreonam) was positively correlated (p < 0.05) with papC and ibeA, but negatively correlated with csgA. These findings underscore the complex interplay between antimicrobial resistance and virulence in Algerian biofilm-producing APEC strains, highlighting the need for enhanced surveillance programs and tailored intervention strategies. This study provides critical baseline data for developing effective control measures against colibacillosis poultry production systems."

Journal

Outbreak of NDM-5-Producing Proteus mirabilis During the COVID-19 Pandemic in an Argentine Hospital. (PubMed, Antibiotics (Basel)) - "Biofilm formation assays and in vitro rifampicin susceptibility tests were also conducted. Most isolates exhibited resistance to carbapenems, cephalosporins, aminoglycosides, and fluoroquinolones, while retaining susceptibility to aztreonam...The absence of surveillance cultures from the index case limits insights into the outbreak's origin. These findings underscore the importance of integrating genomic surveillance into infection control protocols to mitigate the spread of MDR pathogens."

Journal • Infectious Disease • Novel Coronavirus Disease

Analysis of characteristics and prognosis of multi-drug resistant Pseudomonas aeruginosa pulmonary infection in elderly patients. (PubMed, Pak J Pharm Sci) - "Among MDRPA strains isolated, resistance rates were highest for aztreonam (79.66%), ticarcillin (59.32%), and piperacillin (53.39%), and lowest for tobramycin (15.25%), amikacin (16.49%), and gentamicin (19.49%). The resistance situation was severe, particularly for aztreonam, ticarcillin and piperacillin. Admission to ICU was a significant predictor of poor prognosis, while age, history of diabetes and cardiovascular diseases also had a notable impact on prognosis."

Journal • Retrospective data • Cardiovascular • Diabetes • Infectious Disease • Metabolic Disorders • Respiratory Diseases

Improved diagnostic stewardship in carbapenem-resistant Enterobacterales gene detection helps in early initiation of targeted therapy. (PubMed, J Med Microbiol) - "Synergy test guided effective combination therapy of ceftazidime-avibactam and aztreonam for MBL-producing CRE isolates.Conclusion. However, discrepancies between phenotypic and genotypic methods and the high cost of certain therapies are notable limitations. Enhanced infection control and early initiation of targeted therapy are crucial to combat AMR."

Journal • Infectious Disease • Pneumonia

Antimicrobial-resistant Pseudomonas aeruginosa isolates from Brazilian environmental sources: a 13-year laboratory-based retrospective analysis. (PubMed, Environ Monit Assess) - "The patterns of antimicrobial susceptibility showed resistance mainly for aztreonam (32%) and colistin (24%). No carbapenemases and MCR-type were found, suggesting unusual acquired or mutational mechanisms. The results warn about the spread of antimicrobial-resistant P. aeruginosa in different environments and how anthropogenic actions can shape the presence of this bacteria in specific environmental niches over the years."

Journal • Retrospective data

Comparison of the Lifescale Gram Negative Kit to the Microscan Gram Negative Minimum Inhibitor Concentrations Panel Type 56 for Antimicrobial Susceptibility Testing (ASM Microbe 2025) - "14 antibiotics were evaluated: amikacin, ampicillin, aztreonam, cefazolin, cefepime, ceftazidime, ceftazidime/avibactam, ertapenem, gentamicin, levofloxacin, meropenem, meropenem/vaborbactam, piperacillin/tazobactam, and trimethoprim/sulfamethoxazole. In this study, the AST results provided by the LifeScale system were in high agreement with the SOC AST results for the most common Gram-negative bacteria recovered in our patient population. The simplicity and rapid time to results of this novel platform should have a positive impact on implementation of targeted therapy for bacteremic patients."

Gram negative • Infectious Disease • Pneumonia

Hit or Miss: Quantitative Evaluation of the Impact of Polymyxin B on the Outer Membrane Penetration of β-Lactams in PDR Klebsiella pneumoniae (ASM Microbe 2025) - "Using liquid chromatography-tandem mass spectrometry (LC-MS/MS), we simultaneously quantified the degradation of three β-lactams (e.g., Imipenem [IMP], Ceftazidime [CEF], and Aztreonam [AZT]) in intact and lysed bacteria, with and without PB pretreatment. This study provides the first quantitative evaluation of PB's impact on the OM permeability of multiple β-lactams in a PDR KP clinical isolate. By quantifying OM permeability, we contribute to understanding the mechanisms of antimicrobial resistance and provide a foundation for optimizing β-lactam and polymyxin combination therapies to combat PDR infections."

Infectious Disease • Pneumonia

The Fair, the Foul, and the Filamentous: Aztreonam/Avibactam Overcomes Strain-Specific Phenotypic Variability in Klebsiella pneumoniae When Targeting PBP-2 and PBP-3 (ASM Microbe 2025) - "Here, we assessed the pharmacodynamics and phenotypic responsiveness to mono and combination therapies involving aztreonam (ATM), ceftibuten (CBT), and avibactam (AVI) in several resistant isolates. ATM-induced filamentation is not consistent across resistant Kp isolates. Independent of strain-specific responses to monotherapy, ATM+AVI proved to be the superior combination as it produces a universal bulging elongated rod/filament intermediary phenotype that gives way to a "pop and kill mechanism"."

Infectious Disease • Pneumonia

Emergence of Resistance and Hyper-Susceptibility in Enterobacterales and Pseudomonas aeruginosa to Diazabicyclooctane (DBO) β-Lactamase Inhibitors (ASM Microbe 2025) - "A high-throughput inkjet printer-based susceptibility testing method is used to establish baseline susceptibility of drug-resistant Enterobacterales and P.aeruginosa strains to DBOs, both alone and in combination with five β-lactams (aztreonam, meropenem, cefepime, ceftazidime, mecillinam)...Carbapenemase-producing strains had higher mutation frequencies than non-producers in response to the cefepime/zidebactam combination, with P.aeruginosa strains exhibiting the highest rates...Mutations linked to carbapenemase loss will be investigated using whole-genome sequencing. These findings have important implications for the role of new BL/DBO combinations in clinical development."

Infectious Disease

Evaluation of the ASTar® System for Rapid Susceptibility Testing Directly from Positive Blood Cultures from Oncology Patients with Bloodstream Infections (ASM Microbe 2025) - "The ASTar® panel was performed according to manufacturer's instructions and organisms were tested across 18 antimicrobials: amikacin, ampicillin, ampicillin/sulbactam, aztreonam, cefazolin, cefepime, ceftazidime, cefuroxime, ceftazidime/avibactam, ciprofloxacin, gentamicin, levofloxacin, meropenem, meropenem/vaborbactam, piperacillin/tazobactam, tobramycin, tigecyline, and trimethoprim/sulfamethoxazole. The ASTar® system yields reliable AST results with an overall CA of 94% and 99% EA. The ASTar® system combined with direct from positive blood rapid identification can help in the optimization of early antimicrobial therapy in patients with bloodstream infections."

Infectious Disease • Oncology • Pneumonia • Septic Shock

Have You Seem Kerstersia gyiorium on the Bench? Reliable Identification Method and Susceptibility Profile (ASM Microbe 2025) - "Susceptibility was obtained by VITEK® 2 AST-GN801 (bioMerieux, Inc.) applying non-fermenter CLSI breakpoints Final identification of K. gyiorium was achieved by WGS...Only 76.92% were susceptible to Aztreonam and 70.59% to Piperacillin/Tazobactam. 88.89% were susceptible to Levofloxacin but 70.37% were resistant to Ciprofloxacin Conclusion K. gyiorium has been frequently isolated from different sources, but only a few reports. Final identification of K. gyiorium was achieved by WGS. All isolates were 100% susceptible to Aminoglycosides, Carbapenems and Tetracyclines. 90% and 96.15% were susceptible to Cefepime and Ceftazidime, respectively."

Infectious Disease • Otorhinolaryngology • Respiratory Diseases

Genomic Diversity, Virulence Factors, and Antibiotic Resistance in Achromobacter xylosoxidans (ASM Microbe 2025) - "Antibiotic susceptibility testing of isolates from the United States revealed high resistance to Ceftolozane/Tazobactam, Aztreonam, Cefepime, and Ciprofloxacin. Interestingly, virulence assays showed significant variation in the ability of different A. xylosoxidans isolates to induce cell death in in vitro models.These findings highlight the complexity of this pathogen group and emphasize the urgent need for further research into their mechanisms of antibiotic resistance and virulence"

Cardiovascular • CNS Disorders • Infectious Disease • Pertussis • Pneumonia • Respiratory Diseases

Validation of VITEK 2 AST-N807 and AST-XN30 Susceptibility Cards for Gram-Negative Antimicrobial Susceptibility Testing (ASM Microbe 2025) - "The final VME rate was 0.6% (3/536), with aztreonam at 5.9% (1/17), imipenem/relebactam at 11.1% (1/9), and ceftazidime/avibactam at 10.0% (1/10). Overall ME rate was 0.7% (3/430), with cefepime at 5.6% (2/36) and ciprofloxacin at 2.8% (1/36). The overall minor error (mE) rate was 7.0% (71/1017), with higher mE rates observed with ceftazidime (18.3%: 13/71), tigecycline (19.0%: 4/21), and nitrofurantoin (30.0%: 3/10)...The VITEK® 2 AST-N807 and AST-XN30 susceptibility cards demonstrated acceptable performance for most antibiotics tested, meeting FDA criteria for CA, EA, and error rates. This validation supports the use of these cards for routine clinical use, with considerations for specific antibiotic limitations."

Gram negative • Infectious Disease