GRAM-NEGATIVE INFECTIONS: Edited by Matteo BassettiThe ideal patient profile for new beta-lactam/beta-lactamase inhibitorsMontravers, Philippea; Bassetti, MatteobAuthor Information aDépartement d’anesthésie-réanimation, CHU Bichat-Claude Bernard, APHP, Université Paris Diderot, PRESS Sorbonne Cité, INSERM UMR 1152, Paris, France bInfectious Diseases Division, Department of Medicine University of Udine and Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy Correspondence to Philippe Montravers, Département d’anesthésie réanimation, CHU Bichat-Claude Bernard, APHP, Université Paris Diderot, PRESS Sorbonne Cité, INSERM UMR 1152, Paris, France. E-mail: [email protected] Current Opinion in Infectious Diseases: December 2018 - Volume 31 - Issue 6 - p 587-593 doi: 10.1097/QCO.0000000000000490 Buy Metrics Abstract Purpose of review The worldwide spread of extended-spectrum beta-lactamase (ESBL)-producing bacteria, the overuse of carbapenems, the emergence of carbapenemase-producing organisms and the growing importance of multidrug-resistant and/or extended drug-resistant strains have totally changed prescribers’ habits, leading to very few treatment options in many cases. Beta-lactam/beta-lactamase inhibitor (BLBLI) combinations should be considered as an alternative to carbapenems for treating ESBL-producing bacteria and Pseudomonas aeruginosa infections. The purpose of this study was to provide insight concerning the patients who would constitute ideal candidates to receive these new BLBLI combinations. Recent findings Ceftolozane/tazobactam and ceftazidime/avibactam are the first drugs constituting the use of new beta-lactamase inhibitors. Ceftolozane/tazobactam is the drug of choice for treating MDR/XDR P. aeruginosa infections. Ceftazidime/avibactam is the best drug available for treating KPC and OXA-48 carbapenemase-producing Enterobacteriaceae. Ceftolozane/tazobactam and ceftazidime/avibactam are both carbapenem-sparing agents for treating ESBL-producing Enterobacteriaceae. The role of carbapenem/inhibitors remains to be clarified. Summary Each BLBLI combination has distinctive specificities and limitations that need to be investigated cautiously. Randomized trials will play a key role in defining the best strategies. Infection control measures and prompt diagnosis remain fundamental to prevent dissemination of MDR pathogens in healthcare settings and to optimize early antimicrobial treatment. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.