Pfizer announced last week that its novel investigational combination antibiotic for multidrug-resistant bacterial infections has moved a step closer to regulatory approval in Europe.

In a press release, the company said the European Medicines Agency's Committee for Medicinal Products for Human Use (CHMP) recommended the granting of marketing authorization for Emblaveo (aztreonam-avibactam) for treating adults with complicated intra-abdominal infections, hospital-acquired pneumonia (including ventilator-associated pneumonia), complicated urinary tract infections (including pyelonephritis), and infections caused by aerobic gram-negative organisms with limited treatment options.

An option for nearly untreatable infections

Jointly developed by Pfizer and Abbvie, Emblaveo combines an old beta-lactam antibiotic (aztreonam) with a newer beta-lactamase inhibitor (avibactam). The combination aims to restore aztreonam's activity against gram-negative bacteria that carry two defense mechanisms—metallo-beta-lactamase (MBL) enzymes and other beta-lactamase enzymes—that confer resistance to nearly all currently available antibiotics.

While aztreonam can evade degradation by MBLs on its own, the addition of avibactam helps restore its activity against other beta-lactamases.

"Gram-negative bacteria are often resistant to multiple drugs, leaving infected patients very ill and at high risk of severe complications, including mortality," said James Rusnak, MD, PhD, Pfizer's senior vice president and chief development officer for internal medicine, anti-infectives and hospital. "If approved, Emblaveo could offer hope to adult patients with life-threatening Gram-negative bacterial infections that currently have limited treatment options."

The European Commission will review the CHMP recommendation and is expected to decide whether to grant central marketing authorizations in the European Union in the coming months.

If approved, Emblaveo could offer hope to adult patients with life-threatening Gram-negative bacterial infections that currently have limited treatment options.

A dengue outbreak that has sickened at least 549 Puerto Ricans so far this year—most in the capital city, San Juan—has caused public health officials in the territory to declare a public health emergency, according to media reports.

The territory last declared an emergency owing to dengue in 2012.

So far this year more than 340 people have been hospitalized and 549 sickened with the debilitating mosquito-borne disease. In all of 2023, 1,293 cases were reported, a total likely to be surpassed in the first half of 2024.

Weather patterns, climate change play a role

According to the Associated Press, higher rainfall and high humidity have contributed to the rise in cases and provided ample breeding grounds for the mosquitos that spread the disease.

According to the World Health Organization (WHO), nearly 80% of the world's 5 million dengue cases reported annually occur in the Western Hemisphere, with South and Central America most greatly affected. Dengue can cause headaches, fever, vomiting, and rash, and in very severe cases death.

Last year saw the highest recorded numbers of the viral illness in the Americas and Caribbean, with more than 4 million cases recorded and 2,000 deaths. Climate change and increasing temperatures have been linked to the ongoing outbreaks. Experts say warmer temperatures allow for broadening of mosquito habitat.

"These infections are a symptom of some big underlying trends happening in the world," said Jeremy Farrar, MD, WHO chief scientist, said in an interview late last year on the 2023 dengue totals.

A Mayo Clinic–led study shows that colorectal cancer surgeries dropped 17.3% in the first 9 months of the COVID-19 pandemic and that more patients were diagnosed as having later-stage disease.

The study, published yesterday in the Journal of the American College of Surgeons, used the National Cancer Database to compare rates of surgeries for colorectal cancer, tumor stages, socioeconomic factors, and other variables among 105,317 patients before and during the pandemic (2019 and 2020).

Colorectal cancer, the third most common cancer in the United States, is being increasingly diagnosed in younger adults, the researchers noted.

10,000 fewer patients had surgery

Surgeries for rectal and colon cancer declined 21% and 16%, respectively, in 2020, corresponding to an overall 17.3% drop. Patients also had a significantly lower rate of early-stage cancer (35.5% vs 38.2%) and a significantly higher rate of advanced tumors (19.2% vs 15.7%), but treatment delays weren't noted after diagnosis. The advanced-cancer burden was greater in Black, uninsured or Medicaid-insured, and lower-income patients.

"We found that approximately 10,000 fewer patients did not have surgery for colorectal cancer in 2020 compared to 2019," senior author David Larson, MD, MBA, of Mayo Clinic, said in an American College of Surgeons news release. "That's a profound decrease."

There may be multiple reasons for the decline, such as screening delays, fear of COVID-19 exposure that deterred some patients from seeking care, and disparities in cancer care that likely worsened during the pandemic, the authors said.