Abstract
Over the past decade, an increasing prevalence of infections caused by non-fermenting Gram-negative bacteria has been reported in many countries. Among these bacteria, Pseudomonasaeruginosa andAcine- tobacter baumannii have been associated with high mortality and treatment failures. Treatment options for multidrug-resistant P.aeruginosa andA. baumannii infections are limited to carbapenems in most cases. The mechanisms of carbapenem resistance have been identified in P.aeruginosa and other Gram-negative non-fermenters, including enzyme production, overexpression of efflux pumps, porin deficiencies, and target-site alterations. This article reviews thein vitro activity of doripenem and compares it with that of imipenem and meropenem against a large collection of non-fermenting Gramnegative bacilli, obtained in worldwide surveillance studies between 2000 and 2010. A detailed examination of the available data demonstrate that doripenem has more potentin vitro antibacterial activity against P.aeruginosa andAcinetobacterspecies compared to other carbapenems. Furthermore, doripenem has a limited ability to select for carbapenem-resistant mutants in vitro.
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