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Surveillance and management of multidrug-resistant microorganisms

, &
Pages 653-679 | Published online: 10 Jan 2014
 

Abstract

Multidrug-resistant organisms are an established and growing worldwide public health problem and few therapeutic options remain available. The traditional antimicrobials (glycopeptides) for multidrug-resistant Gram-positive infections are declining in efficacy. New drugs that are presently available are linezolid, daptomicin and tigecycline, which have well-defined indications for severe infections, and talavancin, which is under Phase III trial for hospital-acquired pneumonia. Unfortunately the therapies available for multidrug-resistant Gram-negatives, including carbapenem-resistant Pseudomonas aeruginosa, Acinetobacter baumannii and Enterobacteriaceae, are limited to only colistin and tigecycline. Both of these drugs are still not registered for severe infections, such as hospital acquired pneumonia. Consequently, as confirmed by scientific evidence, a multidisciplinary approach is needed. Surveillance, infection control procedures, isolation and antimicrobial stewardship should be implemented to reduce multidrug-resistant organism diffusion.

Financial & competing interests disclosure

Giovanni Battista Orsi received honoraria as a speaker for Johnson & Johnson. Mario Venditti received honoraria as a speaker for Pfizer, Novartis, Gilead, Merck Sharp and Dome, AstraZeneca, Glaxo, Astellas, Sanofi Aventis and Johnson & Johnson. Marco Falcone received honoraria as a speaker for Pfizer, Novartis, Merck Sharp and Dome, Astellas and Sanofi Aventis. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

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