Journal
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY
Volume 64, Issue 10, Pages -Publisher
AMER SOC MICROBIOLOGY
DOI: 10.1128/AAC.00397-20
Keywords
metallo-beta-lactamase; treatment; pharmacology; drug development; metalloenzymes
Categories
Funding
- UKRI Innovation Fellowship through the North West MRC Scheme in Clinical Pharmacology
- Roche Pharma
- F2G
- Astellas Pharma
- Spero Therapeutics
- Antabio
- Allecra
- Bugworks
- NAEJA-RGM
- Medical Research Council
- National Institute of Health Research
- FDA
- European Commission
- MRC [MR/N025989/1, MR/R016895/1] Funding Source: UKRI
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Modern medicine is threatened by the global rise of antibiotic resistance, especially among Gram-negative bacteria. Metallo-beta-lactamase (MBL) enzymes are a particular concern and are increasingly disseminated worldwide, though particularly in Asia. Many MBL producers have multiple further drug resistances, leaving few obvious treatment options. Nonetheless, and more encouragingly, MBLs may be less effective agents of carbapenem resistance in vivo, under zinc limitation, than in vitro. Owing to their unique structure and function and their diversity, MBLs pose a particular challenge for drug development. They evade all recently licensed beta-lactam-beta-lactamase inhibitor combinations, although several stable agents and inhibitor combinations are at various stages in the development pipeline. These potential therapies, along with the epidemiology of producers and current treatment options, are the focus of this review.
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