he increase in antibiotic resistance raises concerns that, at least in some regions, we are returning to a pre-antibiotic era, in particular for Gram-negative infections. The increased prevalence of extended-spectrum serine-β-lactamases (SBLs) and metallo-β-lactamases (MBLs) means β-lactams are increasingly ineffective in treating Gram-negative infections 1,2 . The advent of mobilized colistin resistance-1 in 2015 3 and transferable tigecycline resistance genes (tetX3-tetX5) in 2019 4 , which mediate resistance to colistin and tigecycline, respectively, means all clinically vital antibiotics for serious Gram-negative infections are compromised.
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