Synthetic approaches towards avibactam and other diazabicyclooctane β-lactamase inhibitors

Avibactam is a non β-lactam β-lactamase inhibitor that has recently been approved in association with a β-lactam antibiotic for the treatment of severe infections caused by otherwise resistant bacteria. Its therapeutic success encouraged the development of many congeners based on its particular diazabicyclooctane scaffold. This review presents a detailed overview of the synthetic strategies that have been implemented to acces these complex bicyclic compounds with a particular focus on those that are currently on the market or in clinical trials.