期刊
CURRENT OPINION IN CRITICAL CARE
卷 21, 期 5, 页码 402-411出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MCC.0000000000000235
关键词
combination regimens; gram-negative pathogens; multidrug resistance; new antibiotics
资金
- Pfizer
- MSD
- Gilead
- Teva
- Astellas AstraZeneca
- Bayer
- Basilea
- Novartis
- Shionogi
- Vifor
- Medicines company
- Tetraphase
Purpose of review Increasing rates of life-threatening infections due to multidrug-resistant (MDR) gram-negative bacteria, such as carbapenemase-producer strains, as well as pathogens that are resistant to all current therapeutic options, have been reported. The number of compounds that are currently being developed is still insufficient to control this global threat. We have reviewed the current available options for the treatment of MDR gram-negative infections, including combination regimens employing older antimicrobials and new compounds. Recent findings A limited number of large trials have assessed the treatment options for commonly encountered resistant pathogens (e.g., Klebsiella pneumoniae, Acinetobacter baumanii, Pseudomonas aeruginosa). Antimicrobials that were used in the past, such as colistin and fosfomycin, have been recently resumed and used in association with carbapenems, tigecycline, or aminoglycosides, showing a positive impact on clinical outcomes. New compounds belonging to various antimicrobial classes (e.g. beta-lactamase inhibitors, cephalosporins, glycyclines, aminoglycosides) have been investigated. Summary Only few new molecules have an adequate activity against MDR gram-negative pathogens, especially carbapenemase-producer strains. Among these, ceftozolane/tazobactam has been recently approved for clinical use. Other compounds, such as avibactam combinations, plazomicin, and eravacycline, have shown promising activity in phase 2 and 3 clinical trials.
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