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Cited by 326

The DOI matches its Crossref record; 59 of the 59 references it cites were found in a registry or an index.

Treatment of Infections Due to MDR Gram-Negative Bacteria

Open access
Bassetti, Matteo, Peghin, Maddalena, Vena, Antonio, Giacobbe, Daniele Roberto·2019·Frontiers in Medicine
DOI 10.3389/fmed.2019.00074
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Abstract

The treatment of multidrug-resistant Gram-negative bacteria (MDR-GNB) infections in critically ill patients presents many challenges. Since an effective treatment should be administered as soon as possible, resistance to many antimicrobial classes almost invariably reduces the probability of adequate empirical coverage, with possible unfavorable consequences. In this light, readily available patient’s medical history and updated information about the local microbiological epidemiology remain critical for defining the baseline risk of MDR-GNB infections and firmly guiding empirical treatment choices, with the aim of avoiding both undertreatment and overtreatment. Rapid diagnostics and efficient laboratory workflows are also of paramount importance both for anticipating diagnosis and for rapidly narrowing the antimicrobial spectrum, with de-escalation purposes and in line with antimicrobial stewardship principles. Carbapenem-resistant Enterobacteriaceae, Pseudomonas aeruginosa, and Acinetobacter baumannii are being reported with increasing frequencies worldwide, although with important variability across regions, hospitals and even single wards. In the past few years, new treatment options, such as ceftazidime/avibactam, meropenem/vaborbactam, ceftolozane/tazobactam, and plazomicin have become available, and others will become soon, which have provide some much awaited resources for effectively counteracting severe infections due to these organisms. However, their optimal use should be guaranteed in the long term, for delaying as much as possible the emergence and diffusion of resistance to novel agents. Despite important progresses, PK/PD optimization of dosages and treatment duration in critically ill patients has still some areas of uncertainty requiring further study, that should take into account also resistance selection as a major endpoint. Treatment of severe MDR-GNB infections in critically ill patients in the near future will require an expert and complex clinical reasoning, of course taking into account the peculiar characteristics of the target population, but also the need for adequate empirical coverage and the more and more specific enzyme-level activity of novel antimicrobials with respect to the different resistance mechanisms of MDR-GNB.

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Metadata

Authors
Bassetti, M., Peghin, M., Vena, A., & Giacobbe, D. R.
Venue
Frontiers in Medicine
Publisher
Frontiers Media SA
Published
2019-04-16
Volume
6
Pages
74-74
ISSN
2296-858X (ISSN-L)
DOI
10.3389/fmed.2019.00074
OpenAlex
W2924739878
Cited by
326
References
59
FWCI
12.81
Type
journal article
Language
en
Open access
gold

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CoChat. (2026). Citation check: Treatment of Infections Due to MDR Gram-Negative Bacteria. https://app.cochat.ai/papers/10.3389/fmed.2019.00074
The paper
Bassetti, M., Peghin, M., Vena, A., & Giacobbe, D. R. (2019). Treatment of Infections Due to MDR Gram-Negative Bacteria. Frontiers in Medicine. https://doi.org/10.3389/fmed.2019.00074

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Bibliographic data: Semantic Scholar, OpenAlex, Crossref.

Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.