Antimicrobial treatment challenges in the era of carbapenem resistance

Anna Maria Peri, Y. Doi, Brian A. Potoski, Patrick N.A. Harris, David L. Paterson, Elda Righi

Research output: Contribution to journalReview articlepeer-review

46 Citations (Scopus)


Infections due to carbapenem-resistant Gram-negative bacteria are burdened by high mortality and represent an urgent threat to address. Clinicians are currently at a dawn of a new era in which antibiotic resistance in Gram-negative bacilli is being dealt with by the availability of the first new antibiotics in this field for many years. Although new antibiotics have shown promising results in clinical trials, there is still uncertainty over whether their use will improve clinical outcomes in real world practice. Some observational studies have reported a survival benefit in carbapenem-resistant Enterobacteriaceae bloodstream infections using combination therapy, often including “old” antibiotics such as colistin, aminoglycosides, tigecycline, and carbapenems. These regimens, however, are linked to increased risk of antimicrobial resistance, and their efficacy has yet to be compared to new antimicrobial options. While awaiting more definitive evidence, antibiotic stewards need clear direction on how to optimize the use of old and novel antibiotic options. Furthermore, carbapenem-sparing regimens should be carefully considered as a potential tool to reduce selective antimicrobial pressure.

Original languageEnglish
Pages (from-to)413-425
Number of pages13
JournalDiagnostic Microbiology and Infectious Disease
Issue number4
Publication statusPublished - 08-2019
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Microbiology (medical)
  • Infectious Diseases


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