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Purpose of Review <p> Gram-negative antimicrobial resistance continues to pose a growing threat, particularly among high-priority pathogens such as difficult-to-treat<i>Pseudomonas aeruginosa</i>, carbapenem-resistant <i>Acinetobacter baumannii</i> (CRAB), and carbapenem-resistant Enterobacterales (CRE). The rise in resistance has spurred the development of novel beta-lactam/beta-lactamase inhibitor (BL/BLI) combinations. However, the pace of innovation has lagged behind the rapid emergence of resistance, especially for CRAB and metallo-beta-lactamase (MBL)-producing Enterobacterales, organisms for which effective treatment options have been historically limited. This review outlines the pharmacologic characteristics, activity, and clinical efficacy data for newly approved BL/BLIs</p> Recent Findings <p> The FDA has recently approved Xacduro (sulbactam/durlobactam), Exblifep (cefepime/enmetazobactam), and Emblaveo (aztreonam/avibactam). Additionally, promising pipeline agents such as cefepime/taniborbactam, cefepime/zidebactam, and imipenem/cilastatin/funobactam warrant discussion. These agents offer significant potential to fill longstanding therapeutic gaps.</p> Summary <p> As resistance mechanisms evolve and therapeutic challenges persist, development of novel BL/BLIs will play an increasingly critical role in the management of multidrug-resistant gram-negative infections. </p>

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Filling the Gaps: A Review and Update on Beta-Lactamase Inhibitor Combinations

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月24日

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  • Courtney Jackson,
  • John C. Williamson,
  • Jordan Smith

摘要

Purpose of Review

Gram-negative antimicrobial resistance continues to pose a growing threat, particularly among high-priority pathogens such as difficult-to-treatPseudomonas aeruginosa, carbapenem-resistant Acinetobacter baumannii (CRAB), and carbapenem-resistant Enterobacterales (CRE). The rise in resistance has spurred the development of novel beta-lactam/beta-lactamase inhibitor (BL/BLI) combinations. However, the pace of innovation has lagged behind the rapid emergence of resistance, especially for CRAB and metallo-beta-lactamase (MBL)-producing Enterobacterales, organisms for which effective treatment options have been historically limited. This review outlines the pharmacologic characteristics, activity, and clinical efficacy data for newly approved BL/BLIs

Recent Findings

The FDA has recently approved Xacduro (sulbactam/durlobactam), Exblifep (cefepime/enmetazobactam), and Emblaveo (aztreonam/avibactam). Additionally, promising pipeline agents such as cefepime/taniborbactam, cefepime/zidebactam, and imipenem/cilastatin/funobactam warrant discussion. These agents offer significant potential to fill longstanding therapeutic gaps.

Summary

As resistance mechanisms evolve and therapeutic challenges persist, development of novel BL/BLIs will play an increasingly critical role in the management of multidrug-resistant gram-negative infections.