New Antibiotics for Multidrug-Resistant Bacterial Strains: Latest Research Developments and Future Perspectives

Abstract

The present work aims to examine the worrying problem of antibiotic resistance and the emergence of multidrug-resistant bacterial strains, which have now become really common in hospitals and risk hindering the global control of infectious diseases. After a careful examination of these phenomena and multiple mechanisms that make certain bacteria resistant to specific antibiotics that were originally effective in the treatment of infections caused by the same pathogens, possible strategies to stem antibiotic resistance are analyzed. This paper, therefore, focuses on the most promising new chemical compounds in the current pipeline active against multidrug-resistant organisms that are innovative compared to traditional antibiotics: Firstly, the main antibacterial agents in clinical development (Phase III) from 2017 to 2020 are listed (with special attention on the treatment of infections caused by the pathogens Neisseria gonorrhoeae, including multidrug-resistant isolates, and Clostridium difficile), and then the paper moves on to the new agents of pharmacological interest that have been approved during the same period. They include tetracycline derivatives (eravacycline), fourth generation fluoroquinolones (delafloxacin), new combinations between one β-lactam and one β-lactamase inhibitor (meropenem and vaborbactam), siderophore cephalosporins (cefiderocol), new aminoglycosides (plazomicin), and agents in development for treating drug-resistant TB (pretomanid). It concludes with the advantages that can result from the use of these compounds, also mentioning other approaches, still poorly developed, for combating antibiotic resistance: Nanoparticles delivery systems for antibiotics.

Synergistic Antibiofilm Effect of Thymol and Piperine in Combination with Aminoglycosides Antibiotics against Four Salmonella enterica Serovars

“…The effectiveness of several antibacterial agents is currently decreasing due to the emergence of multidrug-resistant pathogens, which represent a serious challenge to medicine and healthcare [ 1 , 2 ]. One of the main causes of resistance is the formation of biofilms [ 3 ].…”

Effective Antimicrobial Solutions for Eradicating Multi-Resistant and β-Lactamase-Producing Nosocomial Gram-Negative Pathogens

“…In addition, the unmonitored use of this agent in the agricultural sector is considered a major driver of resistance [ 18 ], with the WHO now listing colistin as a crucial last-resort agent. Carbapenem-resistant P. aeruginosa is at the top of the WHO priority list, along with carbapenem-resistant A. baumanii , and ESBL and carbapenemase-producing Enterobacteriaceae (primarily E. coli and K. pneumoniae ), where there is an urgent and unmet need for development of new antibiotics and infection-control strategies [ 19 ]. Certainly, studies conducted highlight the prominence of MDR in these species.…”

Fungal Guttation, a Source of Bioactive Compounds, and Its Ecological Role—A Review

“…There is a strong need for new, biological antimicrobials, because of the increasing resistance to antibiotics and antimicrobial agents among pathogens [ 53 ]. In the past few decades, the number of multidrug-resistant bacterial strains noticeably increased, while at the same time, the range of effective antibiotics introduced to the market diminished [ 53 , 54 , 55 ]. Indeed, prior to the approval of the first siderophore-cephalosporin conjugate in 2020, the latest, previously uncovered class of antibiotics was lipopeptides, represented by daptomycin, discovered in 1986 [ 53 , 55 ].…”

“…In the past few decades, the number of multidrug-resistant bacterial strains noticeably increased, while at the same time, the range of effective antibiotics introduced to the market diminished [ 53 , 54 , 55 ]. Indeed, prior to the approval of the first siderophore-cephalosporin conjugate in 2020, the latest, previously uncovered class of antibiotics was lipopeptides, represented by daptomycin, discovered in 1986 [ 53 , 55 ]. However, secondary metabolism of environmental microorganisms is a potential source of new drugs, as demonstrated by the discovery of the peptide-like teixobactin [ 53 , 56 ].…”