Current progress in antibacterial agents for carbapenem-resistant enterobacterales

Area of Science:

• Infectious Diseases
• Microbiology
• Pharmacology

Background:

• Carbapenem-resistant Enterobacterales (CRE) are critical-priority pathogens identified by the WHO.
• CRE infections present a severe global health threat due to limited treatment options and high mortality.
• Existing therapies face challenges, including emerging resistance and limited efficacy against pan-drug-resistant strains.

Purpose of the Study:

• To comprehensively review current antimicrobial strategies against CRE.
• To evaluate the efficacy and limitations of traditional and novel agents.
• To identify gaps in treatment and propose future research and clinical priorities.

Main Methods:

• Systematic literature review of antimicrobial therapies for CRE.
• Analysis of clinical data on traditional antibiotics (polymyxins, tigecycline).
• Assessment of novel agents (e.g., cefiderocol, ceftazidime-avibactam) and combination therapies.

Main Results:

• Traditional antibiotics show variable efficacy and significant limitations.
• Novel agents and combination therapies offer promise but require more extensive clinical validation.
• Major gaps exist in treating pan-drug-resistant CRE and ensuring global access to new treatments.

Conclusions:

• Further high-quality randomized controlled trials are essential to optimize CRE treatment.
• Rapid diagnostics and global surveillance networks are crucial for effective management and control.
• Continued development of novel agents and combination therapies is necessary to combat the growing threat of CRE.