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One of the most commonly known examples of both antimicrobial resistance and the relationship to the classification of a drug of last resort is the emergence of Staphylococcus aureus (MRSA) (sometimes also referred to as multiple-drug resistant S. aureus due to resistance to non-penicillin antibiotics that some strains of S. aureus have shown ...
Glycopeptide antibiotics are a class of drugs of microbial origin that are composed of glycosylated cyclic or polycyclic nonribosomal peptides.Significant glycopeptide antibiotics include the anti-infective antibiotics vancomycin, teicoplanin, telavancin, ramoplanin, avoparcin and decaplanin, corbomycin, complestatin and the antitumor antibiotic bleomycin.
Linezolid is an antibiotic used for the treatment of infections caused by Gram-positive bacteria that are resistant to other antibiotics. [9] [10] Linezolid is active against most Gram-positive bacteria that cause disease, including streptococci, vancomycin-resistant enterococci (VRE), and methicillin-resistant Staphylococcus aureus (MRSA).
Vancomycin is a glycopeptide antibiotic medication used to treat certain bacterial infections. [7] It is administered intravenously (injection into a vein) to treat complicated skin infections, bloodstream infections, endocarditis, bone and joint infections, and meningitis caused by methicillin-resistant Staphylococcus aureus. [8]
May be more narrow-spectrum than vancomycin, resulting in less bowel microbiota alteration. [9] Nausea (11%), vomiting, and abdominal pain. [10] Bactericidal in susceptible organisms such as C. difficile by inhibiting RNA polymerase, thereby inhibiting protein synthesis. [10] Monobactams; Aztreonam: Azactam: Gram-negative bacteria
When the minimum inhibitory concentration of vancomycin is > 2 µg/mL, alternative antibiotics should be used. The approach is to treat with at least one agent to which the bacteria known to be susceptible by in vitro testing. The agents that are used include daptomycin, linezolid, telavancin, ceftaroline, and quinupristin–dalfopristin.
Narrow-spectrum antibiotics have low propensity to induce bacterial resistance and are less likely to disrupt the microbiome (normal microflora). [3] On the other hand, indiscriminate use of broad-spectrum antibiotics may not only induce the development of bacterial resistance and promote the emergency of multidrug-resistant organisms, but also cause off-target effects due to dysbiosis.
The first in a new class of narrow-spectrum macrocyclic antibiotics, fidaxomicin, has been approved for the treatment of C. difficile colitis. [162] New cephalosporin-lactamase inhibitor combinations also approved include ceftazidime-avibactam and ceftolozane-avibactam for complicated urinary tract infection and intra-abdominal infection.