Abstract
Over the past decade, trends in antimicrobial resistance, epidemiology, and drug development have occurred that affect both the empiric and definite selection of antimicrobials in the septic patient. The rapid spread of highly pathogenic community-associated methicillin resistant Staph aureus (MRSA) requires clinicians to consider the inclusion of empiric coverage for MRSA even in community- acquired sepsis. Moreover, vancomycin appears to be losing its effectiveness, and while a number of new agents with broad gram positive activity have been licensed, none have emerged as clearly superior. An alarming increase in the number of hospital-acquired infections due to multi-drug resistant gram negative bacteria has also occurred, and few new gram negative drugs are in development. Clinicians, faced with Pseudomonas aeruginosa or Acinetobacter baumanii isolates resistant to all commonly used drugs, must resort to toxic older drugs such as colistin or therapy combining drugs not effective as monotherapy. Based on a desire to limit overall antimicrobial use, a re-evaluation of older data in both the neutropenic and non-neutropenic host has called into question the common practice of using combination therapy for some gram negative infections. An emerging consensus advocates emphasizing local unit specific antimicrobial sensitivity data in selecting empiric therapy and determining if combination therapy is required. New antifungal drugs and a better understanding of the risk factors for infection with Candida spp. has altered the approach to empiric and definitive treatment of Candida infections in the septic patient.
Keywords: Sepsis, antimicrobial therapy, septic shock
Current Pharmaceutical Design
Title: New Developments in Antimicrobial Use in Sepsis
Volume: 14 Issue: 19
Author(s): Daniel R. Kaul, Curtis D. Collins and Robert C. Hyzy
Affiliation:
Keywords: Sepsis, antimicrobial therapy, septic shock
Abstract: Over the past decade, trends in antimicrobial resistance, epidemiology, and drug development have occurred that affect both the empiric and definite selection of antimicrobials in the septic patient. The rapid spread of highly pathogenic community-associated methicillin resistant Staph aureus (MRSA) requires clinicians to consider the inclusion of empiric coverage for MRSA even in community- acquired sepsis. Moreover, vancomycin appears to be losing its effectiveness, and while a number of new agents with broad gram positive activity have been licensed, none have emerged as clearly superior. An alarming increase in the number of hospital-acquired infections due to multi-drug resistant gram negative bacteria has also occurred, and few new gram negative drugs are in development. Clinicians, faced with Pseudomonas aeruginosa or Acinetobacter baumanii isolates resistant to all commonly used drugs, must resort to toxic older drugs such as colistin or therapy combining drugs not effective as monotherapy. Based on a desire to limit overall antimicrobial use, a re-evaluation of older data in both the neutropenic and non-neutropenic host has called into question the common practice of using combination therapy for some gram negative infections. An emerging consensus advocates emphasizing local unit specific antimicrobial sensitivity data in selecting empiric therapy and determining if combination therapy is required. New antifungal drugs and a better understanding of the risk factors for infection with Candida spp. has altered the approach to empiric and definitive treatment of Candida infections in the septic patient.
Export Options
About this article
Cite this article as:
Kaul R. Daniel, Collins D. Curtis and Hyzy C. Robert, New Developments in Antimicrobial Use in Sepsis, Current Pharmaceutical Design 2008; 14 (19) . https://dx.doi.org/10.2174/138161208784980608
DOI https://dx.doi.org/10.2174/138161208784980608 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
Call for Papers in Thematic Issues
"Tuberculosis Prevention, Diagnosis and Drug Discovery"
The Nobel Prize-winning discoveries of Mycobacterium tuberculosis and streptomycin have enabled an appropriate diagnosis and an effective treatment of tuberculosis (TB). Since then, many newer diagnosis methods and drugs have been saving millions of lives. Despite advances in the past, TB is still a leading cause of infectious disease mortality ...read more
Current Pharmaceutical challenges in the treatment and diagnosis of neurological dysfunctions
Neurological dysfunctions (MND, ALS, MS, PD, AD, HD, ALS, Autism, OCD etc..) present significant challenges in both diagnosis and treatment, often necessitating innovative approaches and therapeutic interventions. This thematic issue aims to explore the current pharmaceutical landscape surrounding neurological disorders, shedding light on the challenges faced by researchers, clinicians, and ...read more
Emerging and re-emerging diseases
Faced with a possible endemic situation of COVID-19, the world has experienced two important phenomena, the emergence of new infectious diseases and/or the resurgence of previously eradicated infectious diseases. Furthermore, the geographic distribution of such diseases has also undergone changes. This context, in turn, may have a strong relationship with ...read more
Melanoma and Non-Melanoma Skin Cancer Treatment: Standard of Care and Recent Advances
In this thematic issue, we aim to provide a standard of care of the diagnosis and treatment of melanoma and non-melanoma skin cancer. The editor will invite authors from different countries who will write review articles of melanoma and non-melanoma skin cancers. The Diagnosis, Staging, Surgical Treatment, Non-Surgical Treatment all ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Scintigraphic Imaging of Inflammatory Processes
Current Medicinal Chemistry - Anti-Inflammatory & Anti-Allergy Agents The Adult Patient with Eisenmenger Syndrome: A Medical Update after Dana Point Part III: Specific Management and Surgical Aspects
Current Cardiology Reviews Human Immunodeficiency Virus (HIV) and Stroke: Targets for Intervention
Infectious Disorders - Drug Targets Preface
Recent Patents on Anti-Infective Drug Discovery Use of Natural Antimicrobials from a Food Safety Perspective for Control of Staphylococcus aureus
Current Pharmaceutical Biotechnology Ruptured Multiple Mycotic Aneurysms Following Infective Endocarditis: Effectiveness of Catheter-based Techniques Using N-butyl Cyanoacrylate in a Hemorrhage-induced Coagulopathy
Current Medical Imaging Antimicrobial Peptides and Peptidomimetics - Potent Therapeutic Allies for Staphylococcal Infections
Current Pharmaceutical Design Transcatheter Aortic Valve Implantation Infective Endocarditis: Current Data and Implications on Prophylaxis and Management
Current Pharmaceutical Design Can Statins Prevent Progression of Degenerated Aortic Valve Stenosis?
Vascular Disease Prevention (Discontinued) Potential Antibacterial Activity of Yemeni Sidr Honey Against <i>Pseudomonas aeruginosa</i> and <i>Streptococcus pyogenes</i>
Anti-Infective Agents Recent Developments in Antithrombotic Therapy: Will Sodium Warfarin Be a Drug of the Past?
Recent Patents on Cardiovascular Drug Discovery Linezolid in Children: Recent Patents and Advances
Recent Patents on Anti-Infective Drug Discovery Acute Decompensated Heart Failure Update
Current Cardiology Reviews Thrombotic Microangiopathy and Occult Neoplasia
Cardiovascular & Hematological Disorders-Drug Targets Infection and Anemia
Infectious Disorders - Drug Targets Coarctation of the Aorta - The Current State of Surgical and Transcatheter Therapies
Current Cardiology Reviews Ophthalmological and Otological Manifestations in the Antiphospholipid Syndrome
Current Rheumatology Reviews Triple-Valve Endocarditis in a Diabetic Patient: Case Report and Literature Review
Current Cardiology Reviews Importance of Oral Health in Pregnancy: A Mini-symposium
Current Women`s Health Reviews γ-Secretase Inhibitors and Modulators for the Treatment of Alzheimer's Disease: Disappointments and Hopes
Current Topics in Medicinal Chemistry