false
Catalog
Contemporary Questions in Pulmonary and Critical C ...
Are New Antibiotics for Resistant Gram Negatives a ...
Are New Antibiotics for Resistant Gram Negatives a Revolution KOODA
Back to course
Pdf Summary
The document addresses the potential revolution new antibiotics could bring for treating resistant Gram-negative infections, particularly in critical care settings. The short answer given is "No," but it emphasizes the importance of familiarizing oneself with the latest Gram-negative antimicrobials, understanding their approval context, and considering their role in therapy and empiric selection.<br /><br />A patient case highlights a 58-year-old ICU patient with a history of chronic bronchiectasis and resistant Klebsiella pneumoniae. The case reviews previous treatments and current antimicrobial susceptibilities to guide therapy selection.<br /><br />Key discussed antimicrobials include:<br /><br />1. **Ceftazidime/Avibactam**: Effective against certain resistant strains and combinations but not universally successful.<br />2. **Meropenem/Vaborbactam** and **Imipenem/Relebactam**: Show susceptibility for resistant strains.<br />3. **Sulbactam/Durlobactam**: Approved for Acinetobacter species with certain beta-lactamases.<br />4. **Cefiderocol**: Noted for its unique iron siderophore mechanism, but has concerns over increased all-cause mortality.<br />5. **Eravacycline**: Effective against carbapenem-resistant organisms, but lacking Pseudomonas coverage.<br />6. **Plazomicin**: A next-generation aminoglycoside with hopeful results against carbapenemase-producing bacteria, though limited for NDM strains.<br /><br />The document also touches on the importance of understanding local antibiograms and resistance patterns to ensure effective initial therapies. It discusses the challenges of antibiotic approval, often focusing on non-pneumonia infections like UTIs or intra-abdominal infections, where it's easier to demonstrate treatment efficacy. <br /><br />Overall, the communication underscores the complex nature of treating resistant infections and the need for ongoing research, careful drug selection, and collaboration with infectious disease specialists and pharmacists to navigate these challenges effectively.
Keywords
antibiotics
Gram-negative infections
critical care
antimicrobial resistance
Ceftazidime/Avibactam
Meropenem/Vaborbactam
Cefiderocol
antibiotic approval
antibiogram
infectious disease
©
|
American College of Chest Physicians
®
×
Please select your language
1
English