[Bacterial resistance and new therapeutic perspectives].
A PROGRESSING PHENOMENON: Concern about bacterial resistance to antibiotics is growing steadily as new mechanisms of resistance are regularly detected. Cocci have generally remained very antibiotic-sensitive, but resistance is developing. MACROLIDE-RESISTANT STREPTOCOCCI: Streptococci resistance to macrolides is related either to a change in the target, the bacterial ribosome (usually the case), or to an efflux mechanism pushing the antibiotic out of the bacteria before it reaches the target (a mechanism which has been confirmed in different parts of the world). QUINOLONE RESISTANCE: Resistance to quinolones results from a modification of the target, bacterial topo-isomerases, or via an efflux mechanism described in several Gram positive and Gram negative bacteria. HOPES FOR THE FUTURE: New families of antibiotics are currently under evaluation, particularly compounds directed against bacteria resistant to classically used antibiotics. Likewise, several fluoroquinolones are under development. Most have a wide spectrum including Gram positive cocci, particularly enterococci and strict anaerobic bacteria. A rigorously applied antibiotic prescription policy is however required to control bacterial resistance to antibiotics.
Muller-Serieys
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Laboratoire de Bactériologie, CHU Bichat Claude-Bernard, Paris. claudette.muller@bch.ap-hop-paris.fr
D000818:Animals; D000890:Anti-Infective Agents / Q000493:pharmacokinetics / Q000494:pharmacology*; D004195:Disease Models, Animal; D004352:Drug Resistance, Microbial; D004917:Erythromycin / Q000493:pharmacokinetics / Q000494:pharmacology; D024841:Fluoroquinolones; D006801:Humans; D066298:In Vitro Techniques; D018942:Macrolides / Q000493:pharmacokinetics / Q000494:pharmacology; D015363:Quinolones / Q000493:pharmacokinetics / Q000494:pharmacology; D013211:Staphylococcus aureus / Q000187:drug effects*; D013296:Streptococcus pneumoniae / Q000187:drug effects*
D000890:Anti-Infective Agents; D024841:Fluoroquinolones; D018942:Macrolides; D015363:Quinolones; D004917:Erythromycin