Pharmacy Department, Barnes-Jewish Hospital Plaza, St Louis, MO, USA.
Department of Surgery, Washington University in St. Louis, St. Louis, MO, USA.
Expert Opin Pharmacother. 2024 Oct;25(14):1867-1872. doi: 10.1080/14656566.2024.2409950. Epub 2024 Oct 7.
Intra-abdominal infections are becoming increasingly common and can lead to significant morbidity and mortality. The incidence of these infections due to resistant gram-negative organisms is also increasing. Given this resistance, new antibiotic combinations are being developed, often utilizing older antibiotics and newer β-lactamase inhibitors. Aztreonam/avibactam (ATM-AVI) is one of the combination antibiotics, which combines aztreonam, a monobactam, with avibactam, a broad-spectrum β-lactamase inhibitor for the treatment of complicated intra-abdominal infections in combination with metronidazole.
In this drug evaluation manuscript, we provide an overview of intra-abdominal infections and an overview of currently available antimicrobial agents used to treat these infections. ATM-AVI is introduced, including chemistry, pharmacodynamics, pharmacokinetics and clinical studies of this compound.
There are limited treatment options for complicated intra-abdominal infections due to resistant gram-negative organisms, especially those with metallo-β-lactamases. One treatment option for these infections is ATM-AVI, which was recently approved in Europe, in addition to metronidazole. These bacteria are difficult to treat, and this new compound is a safe and effective option for empiric treatment in places with a high incidence of infections due to these bacteria, and also treatment for infections when these resistant bacteria are isolated in culture.
腹腔内感染越来越常见,可导致严重的发病率和死亡率。由于耐药革兰氏阴性菌引起的这些感染的发生率也在增加。鉴于这种耐药性,正在开发新的抗生素组合,通常使用旧的抗生素和新的β-内酰胺酶抑制剂。氨曲南/阿维巴坦(ATM-AVI)是组合抗生素之一,它将氨曲南(一种单环β-内酰胺抗生素)与阿维巴坦(一种广谱β-内酰胺酶抑制剂)结合,用于治疗合并甲硝唑的复杂性腹腔内感染。
在本药物评价手稿中,我们提供了腹腔内感染概述以及目前用于治疗这些感染的抗菌药物概述。介绍了 ATM-AVI,包括该化合物的化学、药效学、药代动力学和临床研究。
由于耐药革兰氏阴性菌,特别是那些具有金属β-内酰胺酶的菌,复杂性腹腔内感染的治疗选择有限。这些感染的一种治疗选择是 ATM-AVI,它最近在欧洲获得批准,除了甲硝唑。这些细菌很难治疗,这种新的化合物是在这些细菌感染发生率高的地方进行经验性治疗的安全有效选择,也是在这些耐药菌在培养中分离出来时进行感染治疗的选择。