Limits...
Current and novel antibiotics against resistant Gram-positive bacteria.

Perez F, Salata RA, Bonomo RA - Infect Drug Resist (2008)

Bottom Line: This review focuses on the new β-lactams with activity against MRSA (ceftobiprole and ceftaroline) and on the new glycopeptides (oritavancin, dalbavancin, and telavancin).It will also consider the role of vancomycin in an era of existing alternatives such as linezolid, daptomycin and tigecycline.Finally, compounds in early development are described, such as iclaprim, friulimicin, and retapamulin, among others.

View Article: PubMed Central - PubMed

Affiliation: Division of Infectious Diseases and HIV Medicine, University Hospitals Case Medical Center, Cleveland OH, USA;

ABSTRACT
The challenge posed by resistance among Gram-positive bacteria, epitomized by methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE) and vancomycin-intermediate and -resistant S. aureus (VISA and VRSA) is being met by a new generation of antimicrobials. This review focuses on the new β-lactams with activity against MRSA (ceftobiprole and ceftaroline) and on the new glycopeptides (oritavancin, dalbavancin, and telavancin). It will also consider the role of vancomycin in an era of existing alternatives such as linezolid, daptomycin and tigecycline. Finally, compounds in early development are described, such as iclaprim, friulimicin, and retapamulin, among others.

No MeSH data available.


Related in: MedlinePlus

Chemical structures of select antibiotics active against Gram-positive cocci.
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC3108725&req=5

f1-idr-1-027: Chemical structures of select antibiotics active against Gram-positive cocci.

Mentions: Bacterial resistance to antibiotics certainly does not represent a novel event. Since the introduction of benzylpenicillins (Figure 1.1), it has been observed that given enough time, bacteria will develop resistance to virtually any antibiotic introduced into clinical practice (Table 1). Currently, antibiotic resistance largely defines the epidemiology and pharmacologic therapy of infectious diseases. β-lactam resistant Gram-positive bacteria provide the best illustration of this phenomenon. The “persistent pathogen”, Staphylococcus aureus, is even more formidable since it manifested resistance to methicillin and other semi-synthetic penicillins, giving rise to the acronym “MRSA” (methicillin resistant S. aureus) (Sabath and Finland 1962). Presently, and perhaps in a more virulent fashion due to its association with Panton-Valentine leucocidin (PVL, an exotoxin active against neutrophils), MRSA has been implicated in a surge of community-acquired infections (CA-MRSA) that is reaching epidemic proportions (Vandenesch et al 2003; King et al 2006; Voyich et al 2006; Labandeira-Rey et al 2007). Unfortunately, the entire class of β-lactam antibiotics currently in use is ineffective for the treatment of methicillin-resistant S. aureus (MRSA) infections. By virtue of its unique mechanism of action on the cell wall, vancomycin (Figure 1.5), the preeminent glycopeptide, became the antibiotic of “last resort” against resistant Gram-positive bacteria. Unfortunately, Enterococcus spp. established itself in the 1990s as a “respected pathogen” in the nosocomial setting, more problematic than in the past because of its frequent resistance to vancomycin (vancomycin-resistant Enterococcus; VRE) (Murray 1990). This unwelcome development, together with the threat of the emergence of vancomycin-intermediate and -resistant S. aureus (VISA and VRSA) (Smith et al 1999), conspire to imperil the status of vancomycin as the “workhorse” antibiotic for the treatment of infections caused by Gram-positive bacteria.


Current and novel antibiotics against resistant Gram-positive bacteria.

Perez F, Salata RA, Bonomo RA - Infect Drug Resist (2008)

Chemical structures of select antibiotics active against Gram-positive cocci.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3108725&req=5

f1-idr-1-027: Chemical structures of select antibiotics active against Gram-positive cocci.
Mentions: Bacterial resistance to antibiotics certainly does not represent a novel event. Since the introduction of benzylpenicillins (Figure 1.1), it has been observed that given enough time, bacteria will develop resistance to virtually any antibiotic introduced into clinical practice (Table 1). Currently, antibiotic resistance largely defines the epidemiology and pharmacologic therapy of infectious diseases. β-lactam resistant Gram-positive bacteria provide the best illustration of this phenomenon. The “persistent pathogen”, Staphylococcus aureus, is even more formidable since it manifested resistance to methicillin and other semi-synthetic penicillins, giving rise to the acronym “MRSA” (methicillin resistant S. aureus) (Sabath and Finland 1962). Presently, and perhaps in a more virulent fashion due to its association with Panton-Valentine leucocidin (PVL, an exotoxin active against neutrophils), MRSA has been implicated in a surge of community-acquired infections (CA-MRSA) that is reaching epidemic proportions (Vandenesch et al 2003; King et al 2006; Voyich et al 2006; Labandeira-Rey et al 2007). Unfortunately, the entire class of β-lactam antibiotics currently in use is ineffective for the treatment of methicillin-resistant S. aureus (MRSA) infections. By virtue of its unique mechanism of action on the cell wall, vancomycin (Figure 1.5), the preeminent glycopeptide, became the antibiotic of “last resort” against resistant Gram-positive bacteria. Unfortunately, Enterococcus spp. established itself in the 1990s as a “respected pathogen” in the nosocomial setting, more problematic than in the past because of its frequent resistance to vancomycin (vancomycin-resistant Enterococcus; VRE) (Murray 1990). This unwelcome development, together with the threat of the emergence of vancomycin-intermediate and -resistant S. aureus (VISA and VRSA) (Smith et al 1999), conspire to imperil the status of vancomycin as the “workhorse” antibiotic for the treatment of infections caused by Gram-positive bacteria.

Bottom Line: This review focuses on the new β-lactams with activity against MRSA (ceftobiprole and ceftaroline) and on the new glycopeptides (oritavancin, dalbavancin, and telavancin).It will also consider the role of vancomycin in an era of existing alternatives such as linezolid, daptomycin and tigecycline.Finally, compounds in early development are described, such as iclaprim, friulimicin, and retapamulin, among others.

View Article: PubMed Central - PubMed

Affiliation: Division of Infectious Diseases and HIV Medicine, University Hospitals Case Medical Center, Cleveland OH, USA;

ABSTRACT
The challenge posed by resistance among Gram-positive bacteria, epitomized by methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE) and vancomycin-intermediate and -resistant S. aureus (VISA and VRSA) is being met by a new generation of antimicrobials. This review focuses on the new β-lactams with activity against MRSA (ceftobiprole and ceftaroline) and on the new glycopeptides (oritavancin, dalbavancin, and telavancin). It will also consider the role of vancomycin in an era of existing alternatives such as linezolid, daptomycin and tigecycline. Finally, compounds in early development are described, such as iclaprim, friulimicin, and retapamulin, among others.

No MeSH data available.


Related in: MedlinePlus