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Nanomechanics of Drug-target Interactions and Antibacterial Resistance Detection
Published on: October 25, 2013
New Gram-positive antibiotics: better than vancomycin?
Sebastiaan J van Hal1, David L Paterson
1Department of Microbiology & Infectious Diseases, Sydney South West Pathology Service - Liverpool, South Western Sydney Local Health Network, NSW, Sydney, Australia. Sebastian.vanHal@sswahs.nsw.gov.au
Current Opinion in Infectious Diseases
|August 17, 2011
Summary
Newer antibiotics show higher cure rates for multidrug-resistant Gram-positive infections than vancomycin, but do not improve survival. Resistance to newer agents like daptomycin and linezolid is a growing concern.
Area of Science:
- Infectious Diseases
- Pharmacology
- Microbiology
Background:
- Vancomycin is a cornerstone for treating multidrug-resistant Gram-positive infections.
- Concerns exist regarding vancomycin's efficacy and the emergence of resistance.
- Evidence for superior outcomes with alternative antibiotics has been limited.
Purpose of the Study:
- To review recent advances in antibiotic therapies for multidrug-resistant Gram-positive pathogens.
- To compare the efficacy and safety of newer agents against vancomycin.
Main Methods:
- Review of recent clinical studies and FDA assessments.
- Comparative analysis of cure rates, mortality, and resistance patterns.
- Evaluation of toxicity profiles for alternative antibiotics.
Main Results:
- Combination therapy with vancomycin-rifampin improved cure rates but increased rifampin resistance.
- Newer agents like ceftaroline, telavancin, and daptomycin showed comparable clinical cure rates to vancomycin for skin infections.
- Telavancin and linezolid demonstrated higher cure rates than vancomycin for hospital-acquired pneumonia, without improving mortality.
- Emergence of resistance to daptomycin and linezolid is a significant concern.
- Toxicity profiles are generally comparable to vancomycin with short-term use.
Conclusions:
- Alternative antibiotics offer improved microbiological and clinical cure rates compared to vancomycin for S. aureus infections.
- These improved cure rates do not translate into significant mortality benefits.
- Careful monitoring for resistance and toxicity is crucial with increased use of newer agents.
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