Mecanismos moleculares y epidemiología de la resistencia a ceftazidima-avibactam: un análisis integral.

In 2015, ceftazidime/avibactam (CZA) was approved for the treatment of complicated infections: urinary, intra-abdominal and hospital-acquired pneumonias caused by multidrug-resistant Gram-negative bacilli. Its approval for pediatric use was in 2019. Despite its initial effectiveness, resistance to CZA has been increasing, reaching 10% globally. This article provides a comprehensive review of the mechanisms of action of CZA. The main resistance mechanism to this antimicrobial, such as mutations in KPC carbapenemase and extended-spectrum beta-lactamases (ESBLs), overexpression of efflux pumps, and porin modification, are detailed. Experimental research is also reviewed to understand the causes of this phenomenon and the emergence of resistance during treatment with CZA is highlighted, underlining the importance of the epidemiology of this resistance to determine the cases in which CZA is the best therapeutic option. [ABSTRACT FROM AUTHOR]