title: Current and prospective treatments for multidrug-resistant gram-positive infections.
abstract: BACKGROUND
  Staphylococcus aureus and Enterococcus spp. are two of the most common organisms causing nosocomial infections today; and are consistently associated with high mortality rates (approximately 20 and 44%, respectively). Resistance among these pathogens to first line agents such as methicillin and vancomycin continues to rise while isolates with reduced susceptibility to newer agents including linezolid and daptomycin continue to emerge, representing a serious concern for clinicians.
  
  
  METHODS
  Mechanisms of action and resistance as well as in vitro and clinical experience in the treatment of resistant staphylococci and enterococci with currently available agents are discussed. Additionally, novel combination regimens showing enhanced efficacy and available data pertaining to prospective therapies including solithromycin, tedizolid, dalbavancin and oritavancin will be covered.
  
  
  CONCLUSIONS
  With an increase in organisms displaying reduced susceptibility to vancomycin and the associated treatment failures, the significance of alternative therapies such as daptomycin, linezolid, ceftaroline, and prospective anti-gram-positive agents is on the rise. As our understanding of antimicrobial pharmacokinetic-pharmacodynamics principles continues to evolve, the selection of highly effective agents and optimization of dosages may lead to improved patient outcomes and delay the development of resistance.
authors.affiliation: University of Kentucky HealthCare, Department of Pharmacy , 800 Rose Street Room H110, Lexington KY 40536 , USA.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Rybak
authors.forename: Katie E
authors.initials: KE
authors.lastname: Barber
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Rybak
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D024901:Drug Resistance, Multiple, Bacterial; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy*; D006801:Humans
chemical_list: D000900:Anti-Bacterial Agents