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

<p dir="ltr"><b>Declarations</b></p><p dir="ltr"><b>Funding</b> The preparation of this review was not supported by any external funding.</p><p dir="ltr"><b>Authorship and Conflict of interest</b> Matt Shirley is a salaried employee of Adis International Ltd/Springer Nature, and declares no relevant conflicts of interest. All authors contributed to this article and are responsible for its content.</p><p dir="ltr"><b>Ethics approval, Consent to participate, Consent to publish, Availability of data and material, Code availability </b>Not applicable.</p><p dir="ltr">Additional information about this Adis Drug Review can be found <a href="http://www.springer.com/gp/adis/products-services/adis-journals-newsletters/adis-drug-reviews" rel="noreferrer noopener" target="_blank">here</a>.</p><p dir="ltr"><b>Abstract</b></p><p dir="ltr">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 <i>Stenotrophomonas maltophilia</i>, 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.</p><p dir="ltr">© The Author(s), under exclusive licence to Springer Nature Switzerland AG 2025</p>