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Pathogens
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Beta Lactamases: A Weapon Against Antibiotics
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Beta Lactamases: A Weapon Against Antibiotics

A special issue of Pathogens (ISSN 2076-0817). This special issue belongs to the section "Bacterial Pathogens".

Deadline for manuscript submissions: closed (28 February 2025) | Viewed by 2209

Special Issue Editor

Dr. Elisabete Machado

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Guest Editor
1. FP-BHS—Fernando Pessoa Biomedical and Health Sciences Research Unit, University Fernando Pessoa, 4249-004 Porto, Portugal
2. UCIBIO-REQUIMTE—Applied Molecular Biosciences Research Unit, Laboratory of Microbiology, Faculty of Pharmacy, University of Porto, 4099-002 Porto, Portugal
Interests: antimicrobial resistance and infectious diseases; enterobacterales; β-Lactamases; epidemiology of antimicrobial resistance (clones, mobile genetic elements, healthcare institutions, community); role of non-hospital ecological niches in the selection and dissemination of clinically relevant antibiotic resistance genes
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues，

Beta lactamases are products of bacteria important for various health science disciplines. They have been widely used in nature because they are basic and common biologic survival mechanisms of bacteria used to fight against the biologic products of other living organisms. In particular, for clinical medicine, beta lactamases have considerable significance because they represent a basic mechanism employed by bacteria against the action of antibiotics; from this point of view, beta lactamases are real bacterial weapons used against antibiotics. This leads to bacterial antimicrobial resistance that has been recognized as a major threat for public health in all countries, and it has had considerable global consequences in regards to the morbidity and mortality of patients. Fortunately, modern pharmacology and clinical therapeutics have led to the discovery of the clinical practice of several new combinations of beta lactam antibiotics with beta lactamase inhibitors, as well as basic and clinical research advances. These combination drugs provide pragmatic therapeutic solutions in clinical medicine in cases of a considerable subset of patients exhibiting infections due to bacteria that produce beta lactamases that may inactivate beta lactam antibiotics when administered alone (without the beta lactamase inhibitor).

Dr. Elisabete Machado
Guest Editor

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Keywords

  • beta lactamases
  • bacteria
  • antibiotics
  • antimicrobial resistance

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Published Papers (2 papers)

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Review

13 pages, 231 KiB  
Review
New β-Lactam/β-Lactamase Inhibitor Combination Antibiotics
by Maria Sargianou, Panagiotis Stathopoulos, Christos Vrysis, Iva D. Tzvetanova and Matthew E. Falagas
Pathogens 2025, 14(4), 307; https://doi.org/10.3390/pathogens14040307 - 24 Mar 2025
Viewed by 472
Abstract
The growing problem of infections due to pathogens with antimicrobial resistance, especially Gram-negative bacteria, has led to the development of new β-lactam/β-lactamase inhibitor combination antibiotics. During the last 2 years from the writing of this article, cefepime/enmetazobactam, aztreonam/avibactam, and sulbactam/durlobactam were approved for [...] Read more.
The growing problem of infections due to pathogens with antimicrobial resistance, especially Gram-negative bacteria, has led to the development of new β-lactam/β-lactamase inhibitor combination antibiotics. During the last 2 years from the writing of this article, cefepime/enmetazobactam, aztreonam/avibactam, and sulbactam/durlobactam were approved for use in clinical practice. Cefepime/enmetazobactam targets extended-spectrum β-lactamase (ESBL)-producing Pseudomonas aeruginosa and Enterobacterales. It is indicated for the treatment of patients with complicated urinary tract infections, including pyelonephritis, in Europe and the USA, and also for hospital-acquired pneumonia, ventilator-associated pneumonia, and bacteremia associated with those infections (only in Europe). The antimicrobial spectrum of aztreonam/avibactam includes carbapenem-resistant Enterobacterales. Aztreonam/avibactam is indicated for the treatment of adult patients who suffer from complicated intra-abdominal infections, complicated urinary tract infections including pyelonephritis, hospital-acquired pneumonia, and ventilator-associated pneumonia due to aerobic Gram-negative infections with limited therapeutic options. Sulbactam/durlobactam, a combination of 2 β-lactamase inhibitors, is indicated for the treatment of adult patients with hospital-acquired bacterial pneumonia and ventilator-associated bacterial pneumonia due to the Acinetobacter baumannii–calcoaceticus complex [including carbapenem-resistant Acinetobacter baumannii (CRAB) infections]. Full article
(This article belongs to the Special Issue Beta Lactamases: A Weapon Against Antibiotics)
13 pages, 244 KiB  
Review
β-Lactam/β-Lactamase Inhibitor Combination Antibiotics Under Development
by Angeliki Katsarou, Panagiotis Stathopoulos, Iva D. Tzvetanova, Christina-Maria Asimotou and Matthew E. Falagas
Pathogens 2025, 14(2), 168; https://doi.org/10.3390/pathogens14020168 - 8 Feb 2025
Cited by 1 | Viewed by 1585
Abstract
Antimicrobial resistance remains a public health problem of global concern with a great health and financial burden. Its recognition as a threat by political leadership has boosted the research and development of new antibiotics and particularly novel combinations of β-lactams/β-lactamase inhibitors against multidrug-resistant [...] Read more.
Antimicrobial resistance remains a public health problem of global concern with a great health and financial burden. Its recognition as a threat by political leadership has boosted the research and development of new antibiotics and particularly novel combinations of β-lactams/β-lactamase inhibitors against multidrug-resistant (MDR) Gram-negative pathogens, which remain the major concern in clinical practice. The incorporation of ceftolozane/tazobactam, ceftazidime/avibactam, meropenem/vaborbactam, and imipenem/cilastatin/relebactam has provided new therapeutic options in the treatment of patients with infections due to MDR pathogens. Cefiderocol along with cefepime/enmetazobactam, avibactam/aztreonam, and sulbactam/durlobactam have been recently added to these agents as therapeutic choices, particularly for metallo-β-lactamase producing Gram-negative bacteria. Currently, many combinations are being studied for their in vitro activity against both serine- and metallo-β-lactamases. However, only a few have advanced through phase 1, 2, and 3 clinical trials. Among them, in this article, we focus on the most promising combinations of cefepime/zidebactam, cefepime/taniborbactam, and imipenem/cilastatin/funobactam, which are currently under investigation in phase 3 trials. Full article
(This article belongs to the Special Issue Beta Lactamases: A Weapon Against Antibiotics)
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