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Updated: May 22, 2026

Nanomechanics of Drug-target Interactions and Antibacterial Resistance Detection
Published on: October 25, 2013
[Daptomycin in the context of antimicrobial resistance in Gram-positive bacteria]
Francisco Javier Candel González1
1Servicio de Microbiología Clínica, Hospital Clínico San Carlos, Madrid, España. fj.candel@terra.es
Abstract:
Infection by antimicrobial-resistant Gram-positive bacteria (GPB) is highly prevalent, especially in the hospital setting. The increase in the use of glycopeptides has a microbiological cost: vancomycin-resistant strains (scarce), strains with intermediate sensitivity, heteroresistant and glycopeptide-tolerant strains and glycopeptide-sensitive strains but with a higher minimal inhibitory concentration require a higher dose of vancomycin, increasing toxicity. Because of its pharmacodynamics profile, linezolide has allowed more effective treatment of localized GPB infections in areas with complex spread and in ischemic tissues with little cost in terms of the selection of resistant strains. Similarly, because of its broad spectrum, tigecycline can be used to treat complex mixed infections caused by resistant pathogens. However, because linezolide and tigecycline are bacteriostatic agents, their use in the initial management of bacteremia, endocarditis and infection in immunocompromised hosts is limited. Because daptomycin has potent early bactericidal activity and has not been affected by heteroresistance or tolerance, this drug is an effective alternative against these severe GPB infections.
Insights
Antimicrobial-resistant Gram-positive bacterial infections are common. Daptomycin offers an effective treatment alternative for severe infections, unlike bacteriostatic agents like linezolid and tigecycline.
Area of Science:
- Microbiology
- Infectious Diseases
- Pharmacology
Context:
- Rising prevalence of antimicrobial-resistant Gram-positive bacteria (GPB) in healthcare settings.
- Increasing microbiological cost associated with glycopeptide use, including resistance and tolerance.
- Need for effective treatment strategies against challenging GPB infections.
Purpose:
- To review current therapeutic options for Gram-positive bacterial infections.
- To evaluate the efficacy and limitations of vancomycin, linezolid, tigecycline, and daptomycin.
- To highlight daptomycin as a potent alternative for severe GPB infections.
Summary:
- Glycopeptide use leads to resistance and tolerance issues in GPB.
- Linezolid and tigecycline are bacteriostatic, limiting their use in severe infections.
- Daptomycin exhibits potent early bactericidal activity and is effective against resistant strains.
Impact:
- Provides insights into managing complex Gram-positive bacterial infections.
- Informs clinical decision-making regarding antibiotic selection.
- Suggests daptomycin as a valuable therapeutic option for severe and resistant infections.
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