Infections by multidrug-resistant Gram-negative Bacteria: What's new in our arsenal and what's in the pipeline?

The spread of multidrug-resistant bacteria is an ever-growing concern, particularly among Gram-negative bacteria because of their intrinsic resistance and how quickly they acquire and spread new resistance mechanisms. Treating infections caused by Gram-negative bacteria is a challenge for medical practitioners and increases patient mortality and cost of care globally. This vulnerability, along with strategies to tackle antimicrobial resistance development, prompts the development of new antibiotic agents and exploration of alternative treatment options. This article summarises the new antibiotics that have recently been approved for Gram-negative bacterial infections, looks down the pipeline at promising agents currently in phase I, II, or III clinical trials, and introduces new alternative avenues that show potential in combating multidrug-resistant Gram-negative bacteria.     

Plazomicin的药理学研究及临床应用进展

Plazomicin是美国Achaogen公司开发的新一代氨基糖苷类药物，商品名Zemdri®，近期在美国经FDA批准用于肠杆菌科细菌引起，且其他药物治疗无效的尿路感染及急性肾盂肾炎成人患者的治疗。研究显示，plazomicin抗菌谱广，对多数病原菌中携带的氨基糖苷类修饰酶有良好稳定性，血浆蛋白结合率低，与人体主要肝药酶无相互作用。治疗剂量下，plazomicin对受治感染病例的临床疗效不劣于美罗培南、黏菌素。常见不良反应为轻、中度恶心、呕吐、头晕、腹泻，停药后可恢复。     

Plazomicin: an intravenous aminoglycoside antibacterial for the treatment of complicated urinary tract infections

ABSTRACT

Introduction

Antimicrobial resistance continues to be a major public health concern due to the emergence and spread of multi-drug resistant (MDR) organisms, including extended spectrum ß-lactamase (ESBL) and carbapenemase producing Enterobacterales. Plazomicin is a novel aminoglycoside that demonstrates activity against MDR gram-negatives, including those producing ESBLs and most carbapenemases, and retains activity against aminoglycoside modifying enzymes as a result of structural modifications. The information discussed is meant to assist in identifying plazomicin’s place in therapy and to expand the clinician’s armamentarium.