The challenge of multidrug resistance: the treatment of gram-negative rod infections.
Infections caused by multidrug-resistant gram-negative bacteria are an increasing problem worldwide. Treatment of these microorganisms is a challenge because resistance limits dramatically therapeutic options. In this review, we discuss data of in vitro susceptibility and clinical studies of possible agents for the management of these infections. Currently, published data are limited, and there are no randomized clinical trials involving the treatment of infections caused by multidrug-resistant gram-negative rods. For imipenem-resistant Acinetobacter spp., most studied options are polymyxins and sulbactam. No newer antimicrobials active against Pseudomonas aeruginosa are available or under investigation. Tigecycline presents a broad spectrum of activity in vitro but has been studied mainly as treatment of community-acquired infections, as has ertapenem. They are potential options against extended-spectrum beta-lactamase-producing Enterobacteriaceae, and tigecycline may be useful in treating Acinetobacter infections.
Levin
Anna S
AS
Oliveira
Maura S
MS
D000150:Acinetobacter / Q000187:drug effects; D001424:Bacterial Infections / Q000188:drug therapy*; D002986:Clinical Trials as Topic; D018432:Drug Resistance, Multiple / Q000187:drug effects*; D024901:Drug Resistance, Multiple, Bacterial / Q000187:drug effects; D004755:Enterobacteriaceae / Q000201:enzymology; D000077727:Ertapenem; D006090:Gram-Negative Bacteria / Q000187:drug effects*; D006801:Humans; D008826:Microbial Sensitivity Tests; D008911:Minocycline / Q000031:analogs & derivatives / Q000494:pharmacology; D011113:Polymyxins / Q000494:pharmacology; D011550:Pseudomonas aeruginosa / Q000187:drug effects; D013407:Sulbactam / Q000494:pharmacology; D000078304:Tigecycline; D001618:beta-Lactamases / Q000378:metabolism; D047090:beta-Lactams / Q000494:pharmacology
D011113:Polymyxins; D047090:beta-Lactams; D000078304:Tigecycline; D001618:beta-Lactamases; D008911:Minocycline; D000077727:Ertapenem; D013407:Sulbactam