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Role of old antibiotics in multidrug resistant bacterial infections

R Maviglia1, R Nestorini, M Pennisi

  • 1Department of Emergency Care, Catholic University, Roma, Italy. r.maviglia@mclink.it

Current Drug Targets
|October 6, 2009
PubMed

Insights

Older antibiotics are being reintroduced for multidrug-resistant infections in intensive care units (ICUs). This review details the efficacy and safety of agents like polymyxins, isepamicin, fosfomycin, chloramphenicol, and fusidic acid in critically ill patients.

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Pharmacology

Background:

  • Multidrug-resistant bacterial infections increase mortality and morbidity in ICU patients.
  • Emerging resistance to novel antibiotics necessitates exploring alternative treatments.
  • Older antimicrobial agents are being reconsidered for clinical use.

Purpose of the Study:

  • To review the efficacy and safety of older antimicrobial agents in critically ill patients.
  • To evaluate the role of specific older antibiotics in treating resistant bacterial infections.
  • To provide insights into the reintroduction of established drugs in modern critical care.

Main Methods:

  • Literature review of studies on older antibiotics in intensive care settings.
  • Analysis of efficacy and safety data for agents like polymyxins, isepamicin, fosfomycin, chloramphenicol, and fusidic acid.
  • Examination of combination therapies and specific resistant pathogens.

Main Results:

  • Polymyxins are effective against multidrug-resistant Pseudomonas aeruginosa and Acinetobacter baumannii.
  • Inhaled colistin shows success in treating gram-negative nosocomial pneumonia.
  • Isepamicin, fosfomycin, chloramphenicol, and fusidic acid demonstrate potential utility against specific resistant strains and infections like VRE.

Conclusions:

  • Older antibiotics, including polymyxins, isepamicin, fosfomycin, and fusidic acid, offer valuable therapeutic options for multidrug-resistant infections in ICUs.
  • Combination therapies, such as colistin/rifampicin, may enhance efficacy.
  • Careful consideration of efficacy, safety, and specific resistance patterns is crucial for utilizing these agents effectively.

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