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Current and prospective treatments for multidrug-resistant gram-positive infections

Jeffrey M Rybak1, Katie E Barber, Michael J Rybak

  • 1University of Kentucky HealthCare, Department of Pharmacy , 800 Rose Street Room H110, Lexington KY 40536 , USA.

Expert Opinion on Pharmacotherapy
|July 24, 2013
PubMed
Abstract

Insights

Emerging resistance to antibiotics like vancomycin in Staphylococcus aureus and Enterococcus spp. necessitates exploring alternative therapies. New agents and optimized dosing are crucial for treating these nosocomial infections and preventing further resistance.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Pharmacology

Background:

  • Staphylococcus aureus and Enterococcus spp. are leading causes of nosocomial infections with high mortality rates.
  • Increasing resistance to methicillin and vancomycin, and emerging resistance to linezolid and daptomycin, pose significant clinical challenges.

Purpose of the Study:

  • To review current and novel therapeutic strategies for resistant Gram-positive bacterial infections.
  • To discuss mechanisms of action, resistance, and clinical data for existing and emerging anti-infective agents.

Main Methods:

  • Review of in vitro and clinical data on currently available agents for resistant staphylococci and enterococci.
  • Discussion of novel combination regimens and prospective therapies like solithromycin, tedizolid, dalbavancin, and oritavancin.

Main Results:

  • Limited effectiveness of first-line agents due to rising resistance.
  • Emergence of reduced susceptibility to newer agents like linezolid and daptomycin.

Conclusions:

  • Alternative therapies including daptomycin, linezolid, ceftaroline, and novel anti-Gram-positive agents are increasingly significant due to vancomycin resistance and treatment failures.
  • Advancements in understanding antimicrobial pharmacokinetics-pharmacodynamics can improve patient outcomes and mitigate resistance development through optimized agent selection and dosing.

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