title: Old antibiotics for multidrug-resistant pathogens: from in vitro activity to clinical outcomes.
abstract: Antimicrobial resistance is a major and emerging threat worldwide. New antimicrobials have been unable to meet the resistance challenge, and treatment options are limited for a growing number of resistant pathogens. More and more clinicians are relying on older antimicrobials for the treatment of multidrug-resistant (MDR) bacteria. Some older antimicrobials have maintained excellent in vitro activity against highly resistant pathogens. In some instances, use of older agents is limited by unfavourable pharmacokinetic/pharmacodynamic characteristics and/or toxicities. In general, clinical data pertaining to the use of older agents for the treatment of MDR pathogens are scarce. Research efforts should be focused on the evaluation of older agents for the treatment of MDR pathogens as well as evaluating how these agents perform in complex patient populations with various and multiple co-morbid conditions.
authors.affiliation: University of Michigan Health System, Department of Medicine, Division of Infectious Diseases, Ann Arbor, MI, USA.
authors.forename: Keith S
authors.initials: KS
authors.lastname: Kaye
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Ana C
authors.initials: AC
authors.lastname: Gales
authors.affiliation: Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Fédération de Bactériologie-Hygiène-Virologie, University, Hospital Centre Timone, Institut Hospitalo-Universitaire (IHU) Méditerranée Infection, Assistance Publique-Hôpitaux de Marseille, Marseille, France; Université Aix-Marseille, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE) UM 63 CNRS 7278 IRD 198 INSERM U1095, Facultés de Médecine et de Pharmacie, Marseille, France. Electronic address: greg.dubourg@gmail.com.
authors.forename: Grégory
authors.initials: G
authors.lastname: Dubourg
mesh_terms: D000617:Aminoglycosides / Q000009:adverse effects / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D004338:Drug Combinations; D024901:Drug Resistance, Multiple, Bacterial; D005578:Fosfomycin / Q000009:adverse effects / Q000627:therapeutic use; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D008826:Microbial Sensitivity Tests; D008911:Minocycline / Q000009:adverse effects / Q000627:therapeutic use; D011113:Polymyxins / Q000009:adverse effects / Q000627:therapeutic use; D013419:Sulfamethizole / Q000009:adverse effects / Q000627:therapeutic use; D014295:Trimethoprim / Q000009:adverse effects / Q000627:therapeutic use; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000009:adverse effects / Q000627:therapeutic use; D000096926:Benzenesulfonamides
chemical_list: D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D004338:Drug Combinations; D005578:Fosfomycin; D008911:Minocycline; D011113:Polymyxins; D013419:Sulfamethizole; D014295:Trimethoprim; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; C029078:trimethoprim sulfamethizole; D000096926:Benzenesulfonamides
keywords: Aminoglycosides; Fosfomycin; Multidrug-resistant; Polymyxins; Sulphonamides; Tetracyclines