Novelty and nuance in the intensive care unit: new options to combat multidrug resistant pneumonia. [Review]

MedStar author(s):
Citation: Current Opinion in Infectious Diseases. 34(2):151-155, 2021 04 01.PMID: 33395092Institution: MedStar Washington Hospital CenterDepartment: Medicine/Pulmonary-Critical CareForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Anti-Bacterial Agents/tu [Therapeutic Use] | *Drug Resistance, Multiple, Bacterial | *Gram-Negative Bacterial Infections/dt [Drug Therapy] | *Pneumonia, Bacterial/dt [Drug Therapy] | Gram-Negative Bacteria/de [Drug Effects] | Gram-Negative Bacteria/ph [Physiology] | Gram-Negative Bacterial Infections/mi [Microbiology] | Humans | Intensive Care Units/sn [Statistics & Numerical Data] | Pneumonia, Bacterial/mi [Microbiology]Year: 2021Local holdings: Available online from MWHC library: 1998 - presentISSN:
  • 0951-7375
Name of journal: Current opinion in infectious diseasesAbstract: PURPOSE OF REVIEW: To describe the increasing burden of multidrug resistant (MDR) Gram-negative pathogens in severe pneumonia and to examine the clinical trials supporting a role for novel agents for the treatment of this infection.RECENT FINDINGS: MDR Gram-negative bacteria cause an increasing proportion of severe pneumonias. Although the epidemiology of resistance varies across the globe, all regions have seen an evolution in resistance, especially among Enterobacterales spp, Pseudomonas aeruginosa, and Acinetobacter bumannii. Fortunately, several clinical trials have established the role for multiple new antibiotics in pneumonia. Although these drugs all have different ranges of in vitro activity and potency, each helps to address the problem of MDR. These studies have varied based on the proportion of subjects undergoing mechanical ventilation and the comparator agents employed. Although all these trials have demonstrated noninferiority to the comparator, the mortality rates across the analyses ranged from <% to >20%. None of the recent investigations included immunocompromised subjects.SUMMARY: Multiple new agents exist for treating MDR Gram-negative pneumonia. These agents are not interchangeable. Thus, one must approach their adoption with a nuanced eye. Copyright (c) 2020 Wolters Kluwer Health, Inc. All rights reserved.All authors: Shorr AF, Zilberberg MDOriginally published: Current Opinion in Infectious Diseases. Publish Ahead of Print, 2020 Dec 31.Fiscal year: FY2021Digital Object Identifier: Date added to catalog: 2021-02-17
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 33395092 Available 33395092

Available online from MWHC library: 1998 - present

PURPOSE OF REVIEW: To describe the increasing burden of multidrug resistant (MDR) Gram-negative pathogens in severe pneumonia and to examine the clinical trials supporting a role for novel agents for the treatment of this infection.

RECENT FINDINGS: MDR Gram-negative bacteria cause an increasing proportion of severe pneumonias. Although the epidemiology of resistance varies across the globe, all regions have seen an evolution in resistance, especially among Enterobacterales spp, Pseudomonas aeruginosa, and Acinetobacter bumannii. Fortunately, several clinical trials have established the role for multiple new antibiotics in pneumonia. Although these drugs all have different ranges of in vitro activity and potency, each helps to address the problem of MDR. These studies have varied based on the proportion of subjects undergoing mechanical ventilation and the comparator agents employed. Although all these trials have demonstrated noninferiority to the comparator, the mortality rates across the analyses ranged from <% to >20%. None of the recent investigations included immunocompromised subjects.

SUMMARY: Multiple new agents exist for treating MDR Gram-negative pneumonia. These agents are not interchangeable. Thus, one must approach their adoption with a nuanced eye. Copyright (c) 2020 Wolters Kluwer Health, Inc. All rights reserved.

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