title: The antibiotic pipeline for multi-drug resistant gram negative bacteria: what can we expect?
abstract: A real concern in the medical community is the increasing resistance of bacteria, especially that of Gram-negative types. New antibiotics are currently under clinical development, promising to tackle severe infections caused, especially, by multi-drug resistant (MDR) bacteria and broaden the armamentarium of clinicians.
  
  
  
  We searched PUBMED and GOOGLE databases. Combinations of already approved β-lactams or monobactams with new β-lactamase inhibitors [imipenem-cilastatin/MK-7655 (relebactam), meropenem/RPX7009 (vaborbactam), ceftaroline/avibactam, aztreonam/avibactam], new β-lactams (S-649266, BAL30072), aminoglycosides (plazomicin), quinolones (finafloxacin) and tetracyclines (eravacycline) were included in the review. Expert commentary: For the majority of the upcoming antibiotics the currently available data is limited to their microbiology and pharmacokinetics. Their effectiveness and safety against infections due to MDR bacteria remain to be proved. Significant issues are also the impact of these antibiotics on the human intestinal microbiota and their possible co-administration with already-known antimicrobial agents in difficult-to-treat-infections; further studies should be conducted for these objectives.
authors.affiliation: a Alfa Institute of Biomedical Sciences , Athens , Greece.|b Department of Internal Medicine - Infectious Diseases, Iaso General Hospital , Iaso Group , Athens , Greece.|c Department of Medicine , Tufts University School of Medicine , Boston , MA , USA.
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Falagas
authors.affiliation: d Hellenic Police Health Headquarters , Athens , Greece.
authors.forename: Andreas D
authors.initials: AD
authors.lastname: Mavroudis
authors.affiliation: a Alfa Institute of Biomedical Sciences , Athens , Greece.|b Department of Internal Medicine - Infectious Diseases, Iaso General Hospital , Iaso Group , Athens , Greece.
authors.forename: Konstantinos Z
authors.initials: KZ
authors.lastname: Vardakas
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D019540:Area Under Curve; D004334:Drug Administration Schedule; D024901:Drug Resistance, Multiple, Bacterial / Q000187:drug effects*; D004359:Drug Therapy, Combination; D006090:Gram-Negative Bacteria / Q000187:drug effects* / Q000302:isolation & purification; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology*; D006801:Humans; D008826:Microbial Sensitivity Tests; D016032:Randomized Controlled Trials as Topic
chemical_list: D000900:Anti-Bacterial Agents
keywords: Extensively-drug resistant (XDR) gram-negative; antibiotics; clinical trials; in vitro-in vivo activity; β-lactamases