New Therapeutic Options for Treatment of Multi-drug Resistant Gram-negative Microorganisms
PDF
Cite
Share
Request
Invited Paper
P: 96-101
August 2020

New Therapeutic Options for Treatment of Multi-drug Resistant Gram-negative Microorganisms

J Ankara Univ Fac Med 2020;73(2):96-101
1. Ankara Şehir Hastanesi, Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Kliniği, Ankara, Türkiye
No information available.
No information available
Received Date: 20.01.2020
Accepted Date: 14.05.2020
Publish Date: 21.07.2020
PDF
Cite
Share
Request

ABSTRACT

Recently, antibiotic resistance in gram-negative microorganisms has been increased. While multi-drug resistant and extensively-drug resistant gram-negative strains are the most common cause of healthcare-associated infections, and they are related with high morbidity and mortality. This increase in antimicrobial resistance results in frequently inappropriate use of antibiotics. Effective antibiotic options are decreasing, in proportion to this, new antibiotic development is less than the resistance. However, datas related with on some newly developed and developing antibiotics, which are included in the old antimicrobial classes, are increasing. In this review, it is aimed to present new antibiotic options that are being used and are being developed for the treatment of infections which are caused by antibiotic resistant gram-negative microorganisms are presented. Double carbapenem therapy has been studied and evaluated as a treatment option for carbapenemase producing Enterobacteriaceae. Ceftazidime -avibactam, meropenem - vaborbactam and ceftolozan - tazobactam, which are new beta-lactam beta-lactamase inhibitors, will soon appear to be included in daily clinical practice. In addition, imipenem/cilastatin - relebactam, eravacycline, plasomycin and cefiderocol are new antibiotics that are still being studied for efficacy and safety. Although, with all these new treatment options, we get stronger against infections that are caused by drug resistant gram-negatives, the best way to combat drug resistant microorganisms is to prevent the resistance and spread of resistant clones the rational use of antibiotics.

Keywords: Gram-negative, Antibiotic Resistance, Carbapenemases, Multi-drug Resistance

References

1
Sheu CC, Chang YT, Lin SY, et al. Infections caused by carbapenem-resistant Enterobacteriaceae: An update on therapeutic options. Front Microbiol. 2019;10:80.
2
Willyard C. Drug-resistant bacteria ranked. Nature. 2017;543:15.
3
Shrivastava SR, Shrivastava PS, Ramasamy J. World health organization releases global priority list of antibiotic-resistant bacteria to guide research, discovery, and development of new antibiotics. JMS - J Med Soc. 2018;32:76-77.
4
Frieden T. Antibiotic resistance threats in the United States. Centers Dis Control Prev. 2013;114.
5
Kaye KS, Pogue JM. Infections Caused by Resistant Gram-Negative Bacteria: Epidemiology and Management. Pharmacotherapy. 2015;35:949-962.
6
Bulik CC, Nicolau DP. Double-carbapenem therapy for carbapenemase-producing Klebsiella pneumoniae. Antimicrob Agents Chemother. 2011;55:3002-3004.
7
Anderson KF, Lonsway DR, Rasheed JK, et al. Evaluation of methods to identify the Klebsiella pneumoniae carbapenemase in Enterobacteriaceae. J Clin Microbiol. 2007;45:2723-2725.
8
Mashni O, Nazer L, Le J. Critical Review of Double-Carbapenem Therapy for the Treatment of Carbapenemase-Producing Klebsiella pneumoniae. Ann Pharmacother. 2019;53:70-81.
9
Souli M, Karaiskos I, Masgala A, et al. Double-carbapenem combination as salvage therapy for untreatable infections by KPC-2-producing Klebsiella pneumoniae. Eur J Clin Microbiol Infect Dis. 2017;36:1305-1315.
10
De Pascale G, Martucci G, Montini L, et al. Double carbapenem as a rescue strategy for the treatment of severe carbapenemase-producing Klebsiella pneumoniae infections: A two-center, matched case-control study. Crit Care. 2017;21:1-10.
11
Oliva A, Scorzolini L, Castaldi D, et al. Double-carbapenem regimen, alone or in combination with colistin, in the treatment of infections caused by carbapenem-resistant Klebsiella pneumoniae (CR-Kp). J Infect. 2017;74:103-106.
12
Rodriguez-Baño J, Gutiérrez-Gutiérrez B, Machuca I, Pascual A. Treatment of Infections Caused by Extended-Spectrum-Beta-. Clin Microbiol Rev [Internet]. 2018;31:1-42. Available from: http://cmr.asm.org/content/31/1/e00087-17.full.pdf
13
Bassetti M, Graziano E, Berruti M, et al. The role of fosfomycin for multidrug-resistant gram-negative infections. Curr Opin Infect Dis. 2019;32:617-625.
14
Doi Y. Treatment Options for Carbapenem-resistant Gram-negative Bacterial Infections. Clin Infect Dis. 2019;69:S565-575.
15
Yu W, Shen P, Bao Z, et al. In vitro antibacterial activity of fosfomycin combined with other antimicrobials against KPC-producing Klebsiella pneumoniae. Int J Antimicrob Agents [Internet]. 2017;50:237-241. Available from: http://dx.doi.org/10.1016/j.ijantimicag.2017.03.011
16
Evren E, Azap ÖK, Çolakoğlu Ş, et al. In vitro activity of fosfomycin in combination with imipenem, meropenem, colistin and tigecycline against OXA 48-positive Klebsiella pneumoniae strains. Diagn Microbiol Infect Dis. 2013;76:335-338.
17
Zhao M, Bulman ZP, Lenhard JR, et al. Pharmacodynamics of colistin and fosfomycin: A “treasure trove” combination combats KPC-producing Klebsiella pneumoniae. J Antimicrob Chemother. 2017;72:1985-1990.
18
Michalopoulos A, Virtzili S, Rafailidis P, et al. Intravenous fosfomycin for the treatment of nosocomial infections caused by carbapenem-resistant Klebsiella pneumoniae in critically ill patients: A prospective evaluation. Clin Microbiol Infect [Internet]. 2010;16:184-186. Available from: http://dx.doi.org/10.1111/j.1469-0691.2009.02921.x
19
Pontikis K, Karaiskos I, Bastani S, et al. Outcomes of critically ill intensive care unit patients treated with fosfomycin for infections due to pandrug-resistant and extensively drug-resistant carbapenemase-producing Gram-negative bacteria. Int J Antimicrob Agents [Internet]. 2014;43:52-59. Available from: http://dx.doi.org/10.1016/j.ijantimicag.2013.09.010
20
Liao Y, Hu GH, Xu YF, et al. Retrospective analysis of fosfomycin combinational therapy for sepsis caused by carbapenem-resistant Klebsiella pneumoniae. Exp Ther Med. 2017;13:1003-1010.
21
Merdjan H, Rangaraju M, Tarral A. Safety and Pharmacokinetics of Single and Multiple Ascending Doses of Avibactam Alone and in Combination with Ceftazidime in Healthy Male Volunteers: Results of Two Randomized, Placebo-Controlled Studies. Clin Drug Investig. 2015;35:307-317.
22
Wagenlehner FM, Sobel JD, Newell P, et al. Ceftazidime-avibactam Versus Doripenem for the Treatment of Complicated Urinary Tract Infections, Including Acute Pyelonephritis: RECAPTURE, a Phase 3 Randomized Trial Program. Clin Infect Dis. 2016;63:754-762.
23
Mazuski JE, Gasink LB, Armstrong J, et al. Efficacy and safety of ceftazidime-avibactam plus metronidazole versus meropenem in the treatment of complicated intra-abdominal infection: Results from a randomized, controlled, double-blind, phase 3 program. Clin Infect Dis. 2016;62:1380-1389.
24
Shields RK, Potoski BA, Haidar G, et al. Clinical Outcomes, Drug Toxicity, and Emergence of Ceftazidime-Avibactam Resistance Among Patients Treated for Carbapenem-Resistant Enterobacteriaceae Infections. Clin Infect Dis. 2016;63:1615-1618.
25
Shields RK, Chen L, Cheng S, et al. crossm Emergence of Ceftazidime-Avibactam Mutations during Treatment of. Antimicrob Agents Chemother. 2017;61:1-11.
26
Livermore DM, Mushtaq S. Activity of biapenem (RPX2003) combined with the boronate β-lactamase inhibitor RPX7009 against carbapenem-resistant Enterobacteriaceae. J Antimicrob Chemother. 2013;68:1825-1831.
27
Kaye KS, Bhowmick T, Metallidis S, et al. Effect of meropenem-vaborbactam vs piperacillin-Tazobactam on clinical cure or improvement and microbial eradication in complicated urinary tract infection the TANGO I randomized clinical trial. JAMA - J Am Med Assoc. 2018;319:788-799.
28
Wunderink RG, Giamarellos-Bourboulis EJ, Rahav G, et al. Effect and Safety of Meropenem–Vaborbactam versus Best-Available Therapy in Patients with Carbapenem-Resistant Enterobacteriaceae Infections: The TANGO II Randomized Clinical Trial. Infect Dis Ther [Internet]. 2018;7:439-455. Available from: https://doi.org/10.1007/s40121-018-0214-1
29
Karaiskos I, Lagou S, Pontikis K, et al. The “Old” and the “New” antibiotics for MDR Gram-negative pathogens: For whom, when, and how. Front Public Heal. 2019;7:1-25.
30
Theuretzbacher U. Global antimicrobial resistance in Gram-negative pathogens and clinical need. Curr Opin Microbiol. 2017;39:106-112.
2024 ©️ Galenos Publishing House