ArticleLancet regional health. Americas2025
Mortality of metallo-β-lactamase-producing Enterobacterales bacteremias with combined ceftazidime-avibactam plus aztreonam vs. other active antibiotics: a multicenter target trial emulation.
Article in Lancet regional health. Americas, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Ceftazidime-Avibactam With or Without Aztreonam Versus Other Active Antimicrobials in the Treatment of Bloodstream Infections by Carbapenem-Resistant Klebsiella pneumoniae.Infectious diseases and therapy · 2026Article
- Comparative effectiveness and safety of aztreonam-avibactam or ceftazidime-avibactam plus aztreonam versus best available therapy for severe gram-negative infections: a systematic review, meta-analysis, and trial sequential analysis.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Article
- Treatment Options for Metallo-Beta-Lactamase-ProducingInternational journal of molecular sciences · 2026Review
- Cefiderocol Heteroresistance in NDM-Producing Enterobacterales: A Complex Polymicrobial Infection Successfully Salvaged With Ceftazidime-Avibactam Plus Aztreonam.The American journal of case reports · 2026Article
- Precision Approaches to Carbapenem-Resistant Infections in the ICU: Integrating Diagnostics, Stewardship, and Novel Therapies.Diagnostics (Basel, Switzerland) · 2026Review
- Clinical Characteristics and Outcomes of Bloodstream Infections Caused by Metallo-β-Lactamase-Producing Enterobacterales in Argentina: A Subanalysis of the EMBARCAR Prospective Multicenter Cohort Study.Open forum infectious diseases · 2026Article
- [New antimicrobial substances to combat increasing resistance].Innere Medizin (Heidelberg, Germany) · 2026Review
- Combination of Ceftazidime-Avibactam and Aztreonam Effectively Treated Post-Cardiac Surgery Pneumonia Caused by Hypervirulent KPC- and NDM-ProducingInfection and drug resistance · 2026Article
- Current progress in antibacterial agents for carbapenem-resistant enterobacterales.Frontiers in pharmacology · 2026Review
- The Therapeutic Potential of Cefiderocol in the Treatment of Multidrug-Resistant Gram-Negative Bacteria: A Narrative Review.Journal of clinical medicine · 2025Review
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Authors and funding
31 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Background: Bacteremias caused by metallo-β-lactamase (MBL)-producing Enterobacterales are a critical challenge due to their limited treatment options. Although ceftazidime-avibactam (CAZAVI) combined with aztreonam (ATM) has shown in vitro efficacy, no prior studies have rigorously compared its clinical effectiveness to Other Active Antibiotics (OAAs). This study aims to evaluate the efficacy and safety of CAZAVI + ATM vs. OAAs in a large cohort of MBL bacteremia. Methods: A retrospective, multicenter, target trial emulation was conducted across 17 hospitals in Argentina between January 2016 and October 2024. Patients with confirmed MBL bacteremia who initiated active antibiotic treatment within 24 h of MBL identification and 96 h of blood sampling were included. Inverse probability of treatment weighting (IPTW) was used to reduce indication bias, and the analysis accounted for hospital clustering within Argentina's public, private, and social security health systems. The primary outcome was 30-day all-cause mortality, with secondary outcomes including clinical failure (relapse, complications, or death) and adverse events. Findings: Among 243 patients (93 receiving CAZAVI + ATM and 150 receiving OAAs), the 30-day mortality rate was 35% in the CAZAVI + ATM group vs. 47% in the OAA group (adjusted odds ratio [OR] 0·63, 95% CI 0·43-0·91, p < 0·01). Clinical failure occurred in 46% of the CAZAVI + ATM group and 53% of the OAA group (adjusted hazard ratio [HR] 0·65, 95% CI 0·44-0·97; p = 0·03). Adverse events were lower with CAZAVI + ATM (9·6% vs. 22·8%, p = 0·014). Interpretation: These findings suggest CAZAVI + ATM might be associated with lower mortality, reduced clinical failure, and fewer adverse events compared to OAAs in patients with MBL-type Enterobacterales bacteremia. Further prospective studies are warranted to confirm these observations. Funding: No specific funding was provided for this study.
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