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Pharmacotherapies for multidrug-resistant gram-positive infections: current options and beyond

Sebastiano Leone1, Ilaria Pezone2, Mariantonietta Pisaturo3

  • 1Division of Infectious Diseases, "San Giuseppe Moscati" Hospital, Avellino, Italy.

Expert Opinion on Pharmacotherapy
|June 12, 2024
PubMed
Abstract

Insights

Multidrug-resistant organism (MDRO) infections pose a significant public health threat. This review examines current and developing treatments for Gram-positive MDROs, emphasizing combination therapies.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Pharmacology

Background:

  • Multidrug-resistant organisms (MDROs) present a critical global health challenge, characterized by high rates of illness and death.
  • Optimal treatment strategies for Gram-positive MDRO infections remain a significant concern despite the availability of numerous antibiotics.

Purpose of the Study:

  • To review current therapeutic options for Gram-positive MDRO infections.
  • To explore emerging non-traditional antibacterial agents and their potential role in treatment.

Main Methods:

  • A comprehensive literature search was performed on the PubMed/Medline database.
  • No language or time restrictions were applied to the search.
  • The review synthesizes findings on established and novel antibacterial approaches.

Main Results:

  • Glycopeptides remain the primary treatment for Gram-positive infections, serving as the benchmark in new antibiotic trials.
  • Evidence for non-glycopeptide treatments is primarily derived from post-hoc analyses and meta-analyses.
  • Non-traditional antibacterial agents are under investigation to enhance short-term and effective antibiotic regimens.

Conclusions:

  • Glycopeptides continue to be the cornerstone of Gram-positive MDRO infection management.
  • Non-traditional antibacterial agents show promise, particularly when used adjunctively with existing antibiotic therapies.
  • Further research into combination strategies is essential for combating resistant infections.
Keywords:
Multidrug-resistant organismsanti-Gram-positive antibioticsmethicillin-resistant-staphylococcus aureuspenicillin-non-susceptible streptococcus pneumoniaevancomycin-resistant enterococcus faecium

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