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Aztreonam, when partnered with ceftazidime\/avibactam, has\n                      <jats:italic toggle=\"yes\">in vitro<\/jats:italic>\n                      activity against most MBL-producing\n                      <jats:italic toggle=\"yes\">K. pneumoniae<\/jats:italic>\n                      , but clinical outcomes may be suboptimal. The purpose of this study was to determine if aminoglycosides can enhance the pharmacodynamic activity of ceftazidime\/avibactam plus aztreonam against MBL-producing\n                      <jats:italic toggle=\"yes\">K. pneumoniae<\/jats:italic>\n                      .\n                      <jats:italic toggle=\"yes\">K. pneumoniae<\/jats:italic>\n                      isolates harboring MBL genes (\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>NDM<\/jats:sub>\n                      ,\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>VIM<\/jats:sub>\n                      , and\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>IMP<\/jats:sub>\n                      ) were evaluated in time-kill assays (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 4 isolates) and the hollow fiber infection model (HFIM,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 2 isolates). Clinically relevant doses of antibiotics were simulated in the HFIM, and observed antibiotic exposures represented the upper end of the expected patient plasma concentrations. Resistance was tracked during the HFIM, and confocal microscopy was used to assess cell morphology following antibiotic exposure. Both ceftazidime\/avibactam + aztreonam and plazomicin were effective individually at reducing viable bacterial counts of susceptible MBL-producing\n                      <jats:italic toggle=\"yes\">K. pneumoniae<\/jats:italic>\n                      , particularly in the HFIM. Combination regimens with aminoglycosides (amikacin or plazomicin) occasionally demonstrated synergy using traditional definitions based on viable colony counting, but they were able to consistently reduce bacterial turbidity and the emergence of filamentous cells that were observed during exposure to ceftazidime\/avibactam + aztreonam. Combinations between ceftazidime\/avibactam, aztreonam, and an aminoglycoside are a potentially promising therapeutic strategy to combat the rising threat posed by MBL-producing\n                      <jats:italic toggle=\"yes\">K. pneumoniae<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/aac.01540-25","type":"journal-article","created":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T14:00:17Z","timestamp":1770213617000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":0,"title":["Ceftazidime\/avibactam and aztreonam combined with an aminoglycoside combat metallo-\u03b2-lactamase-producing\n                    <i>Klebsiella pneumoniae<\/i>"],"prefix":"10.1128","volume":"70","author":[{"given":"Arunkumar","family":"Karunanidhi","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02mpq6x41","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Pharmacy Practice, University of Illinois Chicago Retzky College of Pharmacy","place":["Chicago, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nidhi","family":"Singh","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02mpq6x41","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Pharmacy Practice, University of Illinois Chicago Retzky College of Pharmacy","place":["Chicago, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jackson V.","family":"Watkins","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02mpq6x41","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Pharmacy Practice, University of Illinois Chicago Retzky College 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