Revitalizing cephalosporins: The promise of β-lactamase inhibitor combinations

This review explore the rise of multidrug-resistant (MDR) Gram-negative bacteria, highlighting β-lactamase inhibitor combinations as crucial therapeutic options. It examines β-lactam resistance mechanisms, established combinations (e.g., ticarcillin/clavulanic acid, piperacillin/tazobactam), and the clinical efficacy of newer therapies like ceftazidime/avibactam (CAZ-AVI) for carbapenem-resistant <i>Klebsiella pneumoniae</i> (CRKP) and ceftolozane/tazobactam (TOL-TAZ) for MDR <i>Pseudomonas aeruginosa</i>. Additionally, novel combinations (e.g., cefepime-enmetazobactam, cefepime-taniborbactam) are discussed for tackling extensively drug-resistant (XDR) bacteria. Through comparative analyses, this review provides key insights into efficacy, resistance, pharmacokinetics, and safety, guiding researchers in optimizing antimicrobial strategies and clinicians in managing MDR infections, while supporting antibiotic management and future research.