What to Do with the New Antibiotics?

Abstract

Multidrug-resistant Gram-negative bacteria-related infections have become a real public health problem and have exposed the risk of a therapeutic impasse. In recent years, many new antibiotics have been introduced to enrich the therapeutic armamentarium. Among these new molecules, some are mainly of interest for the treatment of the multidrug-resistant infections associated with Pseudomonas aeruginosa (ceftolozane/tazobactam and imipenem/relebactam); others are for carbapenem-resistant infections associated with Enterobacterales (ceftazidime/avibactam, meropenem/vaborbactam); and finally, there are others that are effective on the majority of multidrug-resistant Gram-negative bacilli (cefiderocol). Most international guidelines recommend these new antibiotics in the treatment of microbiologically documented infections. However, given the significant morbidity and mortality of these infections, particularly in the case of inadequate therapy, it is important to consider the place of these antibiotics in probabilistic treatment. Knowledge of the risk factors for multidrug-resistant Gram-negative bacilli (local ecology, prior colonization, failure of prior antibiotic therapy, and source of infection) seems necessary in order to optimize antibiotic prescriptions. In this review, we will assess these different antibiotics according to the epidemiological data.

Registry-Based Retrospective Cohort Study of Mortality among Adults Admitted to Intensive Care Units in Istanbul with Hospital Acquired Pseudomonas aeruginosa Bloodstream-Infection between 2014–2021

“…Additionally, consideration of local resistance patterns is essential in making informed treatment decisions. Furthermore, there is a need for the development of novel strategies aimed at preventing and effectively treating P. aeruginosa BSIs considering these findings [16][17][18].…”

Functionalized Calixarenes as Promising Antibacterial Drugs to Face Antimicrobial Resistance

“…Whether it is a calixarene crown (4 or 7 phenolic units) or oxacalixarene, the activities seem more or less random. Functional groups N,N-bis-alkyl-(7, 8, 11, 13), N,N-bis(2-hydroxyethyl)- (14), or N,N-bis(2-methoxyethyl)-ethanamide (9,12) in the lower rim do not appear to lead to any particular activities.…”

“…The consequence is that, for several years, we have observed a dramatic increase (i) in the number of bacteria resistant to antibiotics, but also (ii) in the number of resistance mechanisms, which ultimately leads to the appearance and the spread of multidrug-resistant (MDR) bacteria. There is currently no evidence that these MDRs are more virulent than wild-type bacteria of the same species, but the small therapeutic arsenal remaining available can sometimes prove ineffective and cause great difficulties in patient care; this raises the risk of therapeutic impasse [9].…”

Three absolute barriers of digital technologies implementation in medicine.

“…Последний антибактериальный препарат вышел на рынок в 2011 году. В обозримом горизонте для появления новых антибиотиков есть несколько молекул, однако может пройти несколько десятков лет, прежде чем они пройдут все этапы клинических исследований, докажут свою эффективность и безопасность, и только потом станут доступны для пациентов [8,9]. 8…”