Treatment Options for Carbapenem-resistant Gram-negative Bacterial Infections.

Abstract

Antimicrobial resistance has become one of the greatest threats to public health, with rising resistance to carbapenems being a particular concern due to the lack of effective and safe alternative treatment options. Carbapenem-resistant gram-negative bacteria of clinical relevance include the Enterobacteriaceae, Pseudomonas aeruginosa, Acinetobacter baumannii, and more recently, Stenotrophomonas maltophilia. Colistin and tigecycline have been used as first-line agents for the treatment of infections caused by these pathogens; however, there are uncertainties regarding their efficacy even when used in combination with other agents. More recently, several new agents with activity against certain carbapenem-resistant pathogens have been approved for clinical use or are reaching late-stage clinical development. They include ceftazidime-avibactam, ceftolozane-tazobactam, meropenem-vaborbactam, imipenem-cilastatin-relebactam, plazomicin, eravacycline, and cefiderocol. In addition, fosfomycin has been redeveloped in a new intravenous formulation. Data regarding the clinical efficacy of these new agents specific to infections caused by carbapenem-resistant pathogens are slowly emerging and appear to generally favor newer agents over previous best available therapy. As more treatment options become widely available for carbapenem-resistant gram-negative infections, the role of antimicrobial stewardship will become crucial in ensuring appropriate and rationale use of these new agents.

• Authors: Yohei Doi
• Journal: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (Clin Infect Dis) Vol. 69 Issue Suppl 7 Pg. S565-S575 (11 13 2019) ISSN: 1537-6591 [Electronic] United States
• PMID: 31724043 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)
• Copyright: © The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America.

Chemical References

• Anti-Bacterial Agents
• Carbapenems

Topics

• Anti-Bacterial Agents (therapeutic use)
• Antimicrobial Stewardship
• Carbapenems (therapeutic use)
• Clinical Trials as Topic
• Drug Resistance, Bacterial
• Forecasting
• Gram-Negative Bacterial Infections (drug therapy)
• Humans
• Public Health