Antibiotic therapy for nonfermenting Gram-negative bacilli infections: future perspectives.

IF 3.6 3区 医学 Q2 INFECTIOUS DISEASES Current Opinion in Infectious Diseases Pub Date : 2023-12-01 Epub Date: 2023-10-16 DOI:10.1097/QCO.0000000000000984
Matteo Bassetti, Nadia Castaldo, Alberto Fantin, Daniele Roberto Giacobbe, Antonio Vena
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Abstract

Purpose of review: Serious infections caused by nonfermenting Gram-negative bacteria (NF-GNB) pose a significant challenge for clinicians due to the limited treatment options available, which are frequently associated with issues of toxicity and unfavourable pharmacokinetic profiles. The aim of this review is to provide a brief overview of the existing data concerning the ongoing development of antiinfective agents targeting NF-GNB.

Recent findings: Several agents exhibiting efficacy against NF-GNB are under clinical investigation. Durlobactam-sulbactam and cefepime-taniborbactam emerge as promising therapeutic avenues against carbapenem-resistant Acinetobacter baumanii . Cefepime-zidebactam may serve as a suitable treatment option for urinary tract infections caused by a wide range of NF-GNB. Cefepime-enmetazobactam demonstrates potent in vitro activity against various NF-GNB strains; however, its role as an anti- Pseudomonal agent is inadequately substantiated by available data. Xeruborbactam is a wide β-lactamase inhibitor that can be associated with a range of agents, enhancing in-vitro activity of these against many NF-GNB, including those resistant to newer, broader spectrum options. Lastly, murepavadin appears to be a potential pathogen-specific solution for severe Pseudomonas infections; however, additional investigation is necessary to establish the safety profile of this compound.

Summary: Each of the novel molecules reviewed possesses an interesting range of in-vitro activity against NF-GNB. In addition, some of them have already been proved effective in vivo, underscoring their potential as future treatment options.

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非发酵性革兰氏阴性杆菌感染的抗生素治疗:未来展望。
综述目的:由于可用的治疗选择有限,非发酵性革兰氏阴性菌(NF-GNB)引起的严重感染对临床医生构成了重大挑战,这通常与毒性和不利的药代动力学特征有关。这篇综述的目的是简要概述有关正在进行的针对NF-GNB的抗感染药物开发的现有数据。最近的发现:几种对NF-GNB有疗效的药物正在进行临床研究。杜洛巴坦-舒巴坦和头孢吡肟-坦尼博巴坦是对抗碳青霉烯耐药性鲍曼不动杆菌的有前景的治疗途径。头孢吡肟-齐德巴坦可能是一种合适的治疗由多种NF-GNB引起的尿路感染的选择。头孢吡肟-恩美他唑巴坦对各种NF-GNB菌株显示出强大的体外活性;然而,其作为抗假单胞菌制剂的作用没有得到充分的数据证实。Xeruborbactam是一种广泛的β-内酰胺酶抑制剂,可与一系列药物联合使用,增强这些药物对许多NF-GNB的体外活性,包括那些对新的、更广泛的选择具有耐药性的药物。最后,murepavadin似乎是严重假单胞菌感染的潜在病原体特异性解决方案;然而,有必要进行额外的调查,以确定该化合物的安全性。综述:综述的每一种新分子都具有一系列有趣的抗NF-GNB的体外活性。此外,其中一些已经被证明在体内有效,这突出了它们作为未来治疗选择的潜力。
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来源期刊
CiteScore
6.70
自引率
2.60%
发文量
121
审稿时长
6-12 weeks
期刊介绍: This reader-friendly, bimonthly resource provides a powerful, broad-based perspective on the most important advances from throughout the world literature. Featuring renowned guest editors and focusing exclusively on two topics, every issue of Current Opinion in Infectious Disease delivers unvarnished, expert assessments of developments from the previous year. Insightful editorials and on-the-mark invited reviews cover key subjects such as HIV infection and AIDS; skin and soft tissue infections; respiratory infections; paediatric and neonatal infections; gastrointestinal infections; tropical and travel-associated diseases; and antimicrobial agents.
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