Abstract
Bacterial resistance to antibiotics is growing up day by day in both community and hospital setting, with a significant impact on the mortality and morbidity rates and the financial burden that is associated. In the last two decades multi drug resistant microorganisms (both hospital- and community-acquired) challenged the scientific groups into developing new antimicrobial compounds that can provide safety in use according to the new regulation, good efficacy patterns, and low resistance profile. In this review we made an evaluation of present data regarding the new classes and the new molecules from already existing classes of antibiotics and the ongoing trends in antimicrobial development. Infectious Diseases Society of America (IDSA) supported a proGram, called “the ′10 × ´20′ initiative”, to develop ten new systemic antibacterial drugs within 2020. The microorganisms mainly involved in the resistance process, so called the ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumanii, Pseudomonas aeruginosa, and enterobacteriaceae) were the main targets. In the era of antimicrobial resistance the new antimicrobial agents like fifth generation cephalosporins, carbapenems, monobactams, β-lactamases inhibitors, aminoglycosides, quinolones, oxazolidones, glycopeptides, and tetracyclines active against Gram-positive pathogens, like vancomycin-resistant S. aureus (VRSA) and MRSA, penicillin-resistant streptococci, and vancomycin resistant Enterococcus (VRE) but also against highly resistant Gram-negative organisms are more than welcome. Of these compounds some are already approved by official agencies, some are still in study, but the need of new antibiotics still does not cover the increasing prevalence of antibiotic-resistant bacterial infections. Therefore the management of antimicrobial resistance should also include fostering coordinated actions by all stakeholders, creating policy guidance, support for surveillance and technical assistance.
Highlights
Bacterial resistance to antibiotics is growing up day by day in both community and hospital setting, increasing mortality and morbidity [1].Nowadays, the continuous development and the spread of bacterial resistances pose some questions about their future and represent a serious threat for their clinical utility, leading to an urgent requirement for new compounds.Multidrug resistance (MDR) bacteria is defined as non-susceptibility to one or more antimicrobials on three or more antimicrobial classes, while strains that are non-susceptible to all antimicrobials, are classified as extreme drug-resistant strains [2]
The results of this study show that single- and infrequent-dosing schedules of oritavancin were as efficient as daily administration and had a similar safety profile in treating complicated skin and skin structure infections (cSSSI) caused by Gram-positive pathogens, including methicillin-resistant Staphylococcus aureus (MRSA) [79,80]
The results provided the first proof of concept for the systemic use of a pleuromutilin antibiotic in the treatment of SSSIs [105]
Summary
Bacterial resistance to antibiotics is growing up day by day in both community and hospital setting, increasing mortality and morbidity [1]. The microorganisms that are mainly involved in the resistance process are the, so called the ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumanii, Pseudomonas aeruginosa, and enterobacteriaceae) emphasizing their capacity to “escape” from common antibacterial treatments [4]. Despite this scenario, since 2000 only three new classes of antibiotics have been introduced to the market for human use and one of those is limited to topical use (Figure 1) [5]. Numerous agencies and professional societies have tried to draw attention to the lack of new antibiotics, especially for MDR Gram-negative pathogens.
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