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State of the Management of Infections Caused by Multidrug-Resistant Gram-Negative Organisms
Arsheena Yassin1, Mariya Huralska2, Jason M Pogue3,4
1Department of Pharmacy, Robert Wood Johnson University Hospital, New Brunswick, New Jersey, USA.
Abstract:
In the past decade, the prevalence of multidrug-resistant gram-negative (MDR-GN) bacterial infections has increased significantly, leading to higher rates of morbidity and mortality. Treating these infections poses numerous challenges, particularly when selecting appropriate empiric therapy for critically ill patients for whom the margin for error is low. Fortunately, the availability of new therapies has improved the treatment landscape, offering safer and more effective options. However, there remains a need to establish and implement optimal clinical and therapeutic approaches for managing these infections. Here, we review strategies for identifying patients at risk for MDR-GN infections, propose a framework for the choice of empiric and definitive treatment, and explore effective multidisciplinary approaches to managing patients in the hospital while ensuring a safe transition to outpatient settings.
Insights
Multidrug-resistant gram-negative infections are rising. This review offers strategies for identifying at-risk patients and outlines a framework for choosing empiric and definitive treatments for better patient outcomes.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Antimicrobial Stewardship
Background:
- Rising prevalence of multidrug-resistant gram-negative (MDR-GN) bacterial infections.
- Increased morbidity and mortality associated with MDR-GN infections.
- Challenges in selecting empiric therapy for critically ill patients.
Approach:
- Review of strategies for identifying patients at risk for MDR-GN infections.
- Proposal of a framework for selecting empiric and definitive treatment.
- Exploration of multidisciplinary management approaches.
Key Points:
- Risk stratification for MDR-GN infections is crucial.
- A structured treatment framework aids in empiric and definitive therapy selection.
- Multidisciplinary collaboration enhances patient management and transition of care.
Conclusions:
- Optimal clinical and therapeutic approaches are needed for MDR-GN infections.
- Newer therapies offer improved safety and efficacy.
- Effective management requires integrated hospital and outpatient strategies.
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