Use of Newer and Repurposed Antibiotics against Gram-Negative Bacteria in Neonates

Kontou, Angeliki; Kourti, Maria; Iosifidis, Εlias; Sarafidis, Kosmas; Roilides, Emmanuel

doi:10.3390/antibiotics12061072

Cited by 8 publications

(3 citation statements)

References 109 publications

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“…A drug that could play a key role in MDR Gram-negative infections is Colistin, a molecule with extremely effective action against this class of bacteria, which was previously excluded due to collateral nephrotoxicity [ 59 ]. Ambreen et al demonstrated positive effects of Colistin in a neonatal population of MDR sepsis in Pakistan with a moderate frequency of related adverse effects (nephrotoxicity: 5.2%; seizures: 13.7%; electrolyte imbalance: 18.3%) [ 61 ].…”

Section: Early-onset Sepsismentioning

confidence: 99%

An Overview of Antibiotic Therapy for Early- and Late-Onset Neonatal Sepsis: Current Strategies and Future Prospects

Boscarino,

Romano,

Iotti

et al. 2024

Antibiotics

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Neonatal sepsis is a clinical syndrome mainly associated with a bacterial infection leading to severe clinical manifestations that could be associated with fatal sequalae. According to the time of onset, neonatal sepsis is categorized as early- (EOS) or late-onset sepsis (LOS). Despite blood culture being the gold standard for diagnosis, it has several limitations, and early diagnosis is not immediate. Consequently, most infants who start empirical antimicrobial therapy do not have an underlying infection. Despite stewardship programs partially reduced this negative trend, in neonatology, antibiotic overuse still persists, and it is associated with several relevant problems, the first of which is the increase in antimicrobial resistance (AMR). Starting with these considerations, we performed a narrative review to summarize the main findings and the future prospects regarding antibiotics use to treat neonatal sepsis. Because of the impact on morbidity and mortality that EOS and LOS entail, it is essential to start an effective and prompt treatment as soon as possible. The use of targeted antibiotics is peremptory as soon as the pathogen in the culture is detected. Although prompt therapy is essential, it should be better assessed whether, when and how to treat neonates with antibiotics, even those at higher risk. Considering that we are certainly in the worrying era defined as the “post-antibiotic era”, it is still essential and urgent to define novel strategies for the development of antibacterial compounds with new targets or mechanisms of action. A future strategy could also be to perform well-designed studies to develop innovative algorithms for improving the etiological diagnosis of infection, allowing for more personalized use of the antibiotics to treat EOS and LOS.

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Section: Early-onset Sepsismentioning

confidence: 99%

An Overview of Antibiotic Therapy for Early- and Late-Onset Neonatal Sepsis: Current Strategies and Future Prospects

Boscarino,

Romano,

Iotti

et al. 2024

Antibiotics

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show abstract

“…The first category comprises various antibiotics that have been modified to overcome antimicrobial resistance. The second category includes a few older antibiotics used in the past for different purposes [24]. Many newer antibiotics include a combination of β-lactam + βlactamase inhibitor, but the microorganisms responsible for neonatal sepsis are resistant to most of these.…”

Section: Older Antibioticsmentioning

confidence: 99%

Reintroduction of Legacy Antibiotics in Neonatal Sepsis: The Special Role of Fosfomycin and Colistin

Baltogianni,

Dermitzaki,

Kosmeri

et al. 2024

Antibiotics

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Neonatal sepsis is a leading cause of morbidity and mortality in neonates, particularly in low- and middle-income countries. The emergence of antimicrobial resistance is a rapidly growing global problem. A significant proportion of the pathogens that commonly cause neonatal sepsis are resistant to multiple antibiotics. Therefore, for the empirical treatment of neonatal sepsis, the repurposing of older antibiotics that are effective against multidrug-resistant pathogens is being investigated. This review aims to provide an overview of current research and experience using the repurposed antibiotics colistin and fosfomycin for the empirical treatment of neonatal sepsis. Based on current knowledge, colistin and fosfomycin may be potentially helpful for the empirical treatment of sepsis in neonates due to their efficacy against a wide range of pathogens and acceptable safety profile.

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“…The first category comprises various antibiotics that have been modified to overcome antimicrobial resistance. The second category includes a few older antibiotics used in the past for different purposes [26]. Many newer antibiotics include a combination of β-lactam + β-lactamase inhibitor, but in most of these, the microorganisms responsible for neonatal sepsis are resistant.…”

Section: Older Antibioticsmentioning

confidence: 99%

Reintroduction of Legacy Antibiotics in Neonatal Sepsis. The Special Role of Fosfomycin and Colistin

Baltogianni,

Dermitzaki,

Kosmeri

et al. 2024

Preprint

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Neonatal sepsis is a leading cause of morbidity and mortality in neonates, particularly in low and middle-income countries. The emergence of antimicrobial resistance is a rapidly growing global problem. A significant proportion of the pathogens that commonly cause neonatal sepsis are resistant to multiple antibiotics. Therefore, for the empirical treatment of neonatal sepsis, the repurposing of older antibiotics that are effective against multidrug-resistant pathogens is being investigated. This review aims to provide an overview of current research and experience using the repurposed antibiotics, Colistin and Fosfomycin, for the empirical treatment of neonatal sepsis. Based on current knowledge, Colistin and Fosfomycin may be potentially helpful for the empirical treatment of sepsis in neonates due to their efficacy against a wide range of pathogens and acceptable safety profile.

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Use of Newer and Repurposed Antibiotics against Gram-Negative Bacteria in Neonates

Cited by 8 publications

References 109 publications

An Overview of Antibiotic Therapy for Early- and Late-Onset Neonatal Sepsis: Current Strategies and Future Prospects

An Overview of Antibiotic Therapy for Early- and Late-Onset Neonatal Sepsis: Current Strategies and Future Prospects

Reintroduction of Legacy Antibiotics in Neonatal Sepsis: The Special Role of Fosfomycin and Colistin

Reintroduction of Legacy Antibiotics in Neonatal Sepsis. The Special Role of Fosfomycin and Colistin

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