Non-Klebsiella pneumoniae Carbapenemase Attributes of the Newer β-lactam/β-lactamase Inhibitors, Part 2: Burkholderia cepacia Complex, Stenotrophomonas maltophilia, and Acinetobacter baumannii.

The β-lactam/β-lactamase inhibitor (BL/BLI) combination drugs, ceftazidime/avibactam, meropenem/vaborbactam, and imipenem/relebactam, have proven especially useful for treating carbapenemase-producing, carbapenem-resistant organisms (CRO), specifically Klebsiella pneumoniae carbapenemases (KPCs). However, non-KPC mechanisms of resistance are rising in prevalence among Gram-negatives and are increasingly challenging to treat. These newer BL/BLIs, including sulbactam/durlobactam, have an array of activity against mechanisms of carbapenem resistance beyond KPC and therefore play an important role in the treatment of non-KPC carbapenem-resistant organisms. This review, the second in a 2-part series, lays out the non-KPC attributes of the newer BL/BLIs with a focus on clinical utility against Burkholderia cepacia complex, Stenotrophomonas maltophilia, Acinetobacter baumannii, and other rare pathogens.