The addition of avibactam renders piperacillin an effective treatment for Mycobacterium abscessus infection in an in vivo model

Treating M. abscessus infection is challenging due to the potent β-lactamase Bla _Mab (Beta-lactamase of M. abscessus ₎ . Avibactam is a non-β-lactam, β-lactamase inhibitor shown to inhibit Bla _Mab . We tested whether avibactem can render piperacillin effective against M. Abscessus. In-vitro, avibactam enhanced the activity of piperacillin by 16-32 fold, with no significant effect on meropenem. In an in-vivo Galleria mellonella model, meropenem and piperacillin/avibactam significantly decreased infection burden compared to untreated controls. Neither piperacillin nor avibactam alone had a significant effect.