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Revisiting "older" antimicrobials in the era of multidrug resistance

Jason M Pogue1, Dror Marchaim, Donald Kaye

  • 1Department of Pharmacy, Detroit Medical Center, and Wayne State University School of Medicine, Detroit, Michigan, USA. jpogue@dmc.org

Pharmacotherapy
|September 20, 2011
PubMed

Insights

Older antimicrobials are crucial for treating multidrug-resistant (MDR) infections due to a lack of new drugs. This review examines the use of established agents like colistin and fosfomycin against MDR pathogens.

Area of Science:

  • Infectious Diseases
  • Pharmacology
  • Microbiology

Background:

  • Rising incidence of multidrug-resistant (MDR) infections.
  • Limited development of novel antimicrobial agents.
  • Need for effective treatment strategies against MDR pathogens.

Purpose of the Study:

  • To review the pharmacology, in vitro activity, and clinical use of older antimicrobial agents.
  • To discuss the role of established antimicrobials in managing MDR infections.
  • To explore strategies for the optimal utilization of older antimicrobial drugs.

Main Methods:

  • Literature review focusing on older antimicrobials (colistin, minocycline, trimethoprim-sulfamethoxazole, fosfomycin).
  • Analysis of in vitro activity against MDR organisms.
  • Examination of clinical experience and efficacy data.
  • Discussion of new antimicrobial agents for MDR pathogens.

Main Results:

  • Older antimicrobials like colistin and fosfomycin show potential in treating MDR infections.
  • These agents may offer advantages such as lower cost and good in vitro activity.
  • Clinical efficacy data for older agents, while sometimes limited, supports their use.
  • Newer agents are also being developed for MDR pathogens.

Conclusions:

  • Older antimicrobials are essential in the current therapeutic landscape for MDR infections.
  • Optimizing the use of these agents (monotherapy vs. combination, dosing) is critical.
  • Further research and strategic implementation are needed to combat the growing threat of MDR organisms.

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