Resistance to beta-lactams in Gram-negative bacilli: relevance and potential therapeutic alternatives

Autores de IIS La Fe

• Víctor García Bustos

  Autor

• Marta Dafne Cabañero Navalón

  Autor

• Miguel Salavert Lletí

  Autor

Grupos

• Infección Grave

Abstract

The indiscriminate and massive antibiotic use in the clinical practice and in agriculture or cattle during the past few decades has produced a serious world health problem that en-tails high morbidity and mortality: the antibiotic multi-drug resistance. In 2017 and 2019, the World Health Organization published a list of urgent threats and priorities in the context of drug resistance, which only included Gram-negative bacteria and specially focused on carbapenem-resistant Acine-tobacter baumannii and Pseudomonas aeruginosa, as well as carbapenem and third generation cephalosporin-resistant Enterobacteriaceae. This scenario emphasizes the need of developing and testing new antibiotics from different families, such as new beta-lactams, highlighting cefiderocol and its original mechanism of action; new beta-lactamase inhibitors, with vaborbactam or relebactam among others; new quinolo-nes such as delafloxacin, and also omadacycline or eravacy-cline, as members of the tetracycline family. The present work reviews the importance and impact of Gram-negative bacterial infections and their resistance mechanisms, and analyzes the current therapeutic paradigm as well as the role of new antibiotics with a promising future in the era of multi and pan-drug resistance. © 2022, Sociedad Espanola de Quiminoterapia. All rights reserved.

Keywords

• Animals; Anti-Bacterial Agents; beta-Lactamase Inhibitors; beta-Lactams; Carbapenems; Cattle; Cephalosporins; Drug Resistance, Multiple, Bacterial; Gram-Negative Bacteria; Gram-Negative Bacterial Infections; Microbial Sensitivity Tests; Quinolones; Tetracyclines; aminoglycoside; avibactam plus ceftazidime; beta lactam; beta lactamase inhibitor; cefiderocol; cephalosporin derivative; cilastatin plus imipenem; delafloxacin; enmetazobactam; eravacycline; meropenem; omadacycline; penicillin derivative; polymyxin; relebactam; vaborbactam; antiinfective agent; beta lactam; beta lactamase inhibitor; carbapenem derivative; cephalosporin derivative; quinolone derivative; tetracycline derivative; abdominal infection; Acinetobacter baumannii; Acinetobacter infection; antibacterial activity; antibiotic resistance; antibiotic sensitivity; antibiotic therapy; antimicrobial activity; Article; bacterial strain; bacterium isolate; carbapenem resistant Acinetobacter baumannii; Clostridium difficile infe