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Updated: Jul 23, 2026
08:46
Implementation of In Vitro Drug Resistance Assays: Maximizing the Potential for Uncovering Clinically Relevant Resistance Mechanisms
Published on: December 9, 2015
Avoiding resistance development to newer drugs: open research lines
Matteo Rinaldi1, Milo Gatti2, Maddalena Giannella1
1Infectious Diseases Unit, Department for Integrated Infectious Risk Management, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences, Alma Mater University of Bologna, Bologna, Italy.
Summary
Preventing resistance to new antibiotics involves optimizing dosing and infusion strategies for novel combination therapies. Non-antimicrobial approaches like phage therapy also show promise in reducing the threat of multidrug-resistant bacteria.
Area of Science:
- Microbiology and Infectious Diseases
- Pharmacology and Therapeutics
- Public Health
Background:
- The rise of multidrug-resistant gram-negative bacteria poses a significant global health challenge.
- Novel antimicrobial agents are crucial but face the threat of emerging resistance.
- Carbapenem-resistant and difficult-to-treat bacteria require urgent attention.
Purpose of the Study:
- To review antimicrobial and non-antimicrobial strategies for preventing or mitigating resistance to novel antibacterial agents.
- To summarize current evidence on optimizing treatment regimens and exploring alternative therapies.
Main Methods:
- A narrative review of English-language articles published in PubMed-MEDLINE within the last 5 years.
- Focused on pharmacokinetic/pharmacodynamic targets, combination vs. monotherapy, and non-antimicrobial interventions.
Main Results:
- Optimizing pharmacokinetic/pharmacodynamic targets, such as continuous infusion and therapeutic drug monitoring, may prevent resistance to novel β-lactam/β-lactamase inhibitor combinations.
- Evidence for routine benefit of combination therapy over monotherapy for novel drugs is currently limited and requires further study with resistance as an endpoint.
- Non-antimicrobial strategies including fecal microbiota transplantation, phage therapy, and immunization show potential in high-risk populations.
Conclusions:
- Current resistance prevention for novel β-lactam/β-lactamase inhibitors relies on optimized dosing and infusion.
- Further research is needed to clarify the benefits of combination regimens, with resistance emergence as a key endpoint.
- Non-antimicrobial interventions are promising adjunctive tools for broader resistance prevention frameworks, especially in high-risk settings.
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