Details

Autor(en) / Beteiligte

• Manfredi, Roberto
• Calza, Leonardo

Titel

The recent evolution of therapeutic weapons against resistant Gram-positive microorganisms

Ist Teil von

• Archivos venezolanos de farmacología y terapéutica, 2008-12, Vol.27 (2), p.92-104

Ort / Verlag

Sociedad Venezolana de Farmacológia y Farmacológia Clínica y Terapéutica. Escuela de Medicina, José Maria Vargas. Cátedra de Farmacológia, piso 3, esquina san jacinto, San José Caracas

Erscheinungsjahr

2008

Quelle

EZB Electronic Journals Library

Beschreibungen/Notizen

• Multiresistant Gram-positive cocci, including Staphylococcus aureus, the group of coagulase-negative staphylococci, Enterococcus faecalis and Enterococcus faecium, as well as Streptococcus pneumoniae and other streptococci, represent emerging pathogens. This issue is especially concerning in the setting of immunocompromised, hospitalized patients, in particular when surgery, invasive procedures, or prosthetic implants are carried out, patients are admitted in intensive care units, or underlying chronic disorders and immunodeficiency are of concern, and broad-spectrum antibiotics are widely used in the environment; moreover, a community spread of resistant Gram-positive cocci has been recognized during recent years. The spectrum of antimicrobials available for an effective management of these relevant infections is significantly threatened by the emerging of methicillin-resistant and more recently glycopeptide-resistant strains. The streptogramine association represented by quinupristin/dalfopristin, the oxazolidinone derivative linezolid, and the recently licensed daptomycin and tigecycline, together with a number of glycopeptides, fluoroquinolones, cephalosporins, and other experimental compounds, represent an effective response. It is due to the innovative mechanisms of action of these compounds, their maintained or enhanced activity against multiresistant pathogens, their effective pharmacokinetic/pharmacodynamic properties, their frequent possibility of synergistic activity with other compounds effective against Gram-positive pathogens, and a diffuse potential for a safe and easy administration, also to compromised patients. The main problems related to the epidemiology of multiresistant gram-positive infection, the potential clinical indications of all recently available compounds compared with the standard of care of treatment of resistant Gram-positive infections, and updated data on efficacy and tolerability of all these compounds, are updated and outlined on the ground of a review of recent literature evidences.