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Preparation of a Blood Culture Pellet for Rapid Bacterial Identification and Antibiotic Susceptibility Testing
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Advances in the therapy of bacterial bloodstream infections

M Giannella1, M Bartoletti1, M Gatti2

  • 1Infectious Diseases Unit, Department of Medical and Surgical Sciences, Policlinico Sant'Orsola Malpighi, University of Bologna, Bologna, Italy.

Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases
|November 17, 2019
PubMed
Abstract

Insights

This review examines antibiotic strategies for bloodstream infections (BSIs), focusing on challenging bacteria like Staphylococcus aureus and resistant Gram-negatives. It highlights the need for optimized dosing and new drugs to combat rising antimicrobial resistance.

Area of Science:

  • Infectious Diseases
  • Pharmacology
  • Microbiology

Background:

  • Advances in bloodstream infection (BSI) management have improved outcomes, but high mortality persists for pathogens like Staphylococcus aureus and Enterococcus spp.
  • Antimicrobial resistance, particularly in Gram-negative bacteria, limits treatment options, driving interest in novel therapeutic approaches.
  • Optimizing antibiotic regimens is crucial for effectively treating complex BSIs.

Purpose of the Study:

  • To review current evidence on antibiotic regimens for bacterial BSIs.
  • Focus on drug selection, combination therapies, and optimal dosing schedules.
  • Address challenging pathogens including methicillin-susceptible and resistant Staphylococcus aureus, vancomycin-resistant enterococci, carbapenem-resistant Enterobacteriaceae, multidrug-resistant Pseudomonas aeruginosa, and carbapenem-resistant Acinetobacter baumannii.

Main Methods:

  • Systematic literature search of MEDLINE.
  • Inclusion of English language publications from the last five years.
  • Focus on evidence relevant to antibiotic choice, combination therapy, and dosing.

Main Results:

  • Identified literature gaps concerning new antimicrobial agents.
  • Highlighted uncertainties in the application of combination antibiotic regimens.
  • Emphasized the need for optimized dosing in specific patient populations and infection scenarios.

Conclusions:

  • Addressing knowledge gaps in new drug utilization is essential.
  • Further research is needed to clarify the role and efficacy of combination regimens.
  • Optimizing antibiotic dosing is critical for specific circumstances, including augmented renal clearance, renal replacement therapy, high bacterial load infections, and isolates with high minimum inhibitory concentrations (MICs).
Keywords:
Bloodstream infectionCombination regimenDosing schedulesNew antibiotics

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