[ICAA 1999: news in antibiotic therapy]

NEW DERIVATIVES OF OLDER COMPOUNDS: Beta-lactamine derivatives include ne penems and carbapenems as well as beta-lactamase inhibitors and a few cephalosporins. Non-fluoroquinolones without a fluoride atom on position 6 have an antibacterial activity at least equivalent to the most active fluorated products available, suggesting that the contribution of the fluroide atom actually is of limited impact in fluoroquinolones. The clinical importance of these new derivatives remains to be documented. New tetracyclin analogs include glycycyclins. These compounds appear to be active against species resistant to this family of drugs. NEW ANTIBIOTIC CLASSES: A few coumarins have interesting antibacterial activities, essentially against Gram-positive resistant germs. Daptomycin, a glycopeptide-like molecule, gives favorable results for the treatment of Gram-positive infections and yet is comparatively less toxic for the kidney and the auditory system. Oxazolidinones, particularly linezolide, are currently indicated for penicillin and glycopeptide resistant Gram-positive strains. PHARMACOLOGY STUDIES: Recent studies have been conducted on ketolides (14-chain derivatives obtained from erythromycin A) and new fluoroquinolones, gemifloxacin and gatifloxacin, which are active against Gram positive germs (S. pneumoniae) and bactericidal against multiresistant Gram negative.