Aztreonam-Avibactam: A Review in the Treatment of Serious Bacterial Infections Caused by Aerobic Gram-Negative Organisms

Aztreonam-avibactam (Emblaveo^™), a fixed-dose combination of the monobactam antibacterial agent aztreonam and the broad-spectrum β-lactamase inhibitor avibactam, has been developed as a treatment, administered intravenously, for serious bacterial infections caused by aerobic Gram-negative organisms. In the EU, aztreonam-avibactam is indicated in adults for the treatment of complicated intra-abdominal infection (cIAI); hospital-acquired pneumonia (HAP), including ventilator-associated pneumonia (VAP); and complicated urinary tract infection (cUTI), including pyelonephritis; as well as for the treatment of other infections due to aerobic Gram-negative organisms in adult patients with limited treatment options. Adding to existing data on aztreonam and avibactam individually, the approval of aztreonam-avibactam was supported by a clinical development programme which included pharmacokinetic and pharmacodynamic modelling and probability of target attainment analyses together with evaluation of the combination in a range of clinical trials. Based on all available data, aztreonam-avibactam is a valuable addition to the treatment options for adults with serious bacterial infections caused by aerobic Gram-negative organisms. Furthermore, with in vitro data showing that the drug combination retains potent activity against metallo-β-lactamase (MBL)-producing Enterobacterales and Stenotrophomonas maltophilia, and noting the limited effective treatment options available for infections caused by such bacteria, aztreonam-avibactam is likely to be particularly useful in regions with a high prevalence of MBLs.