Spotlight on New Antibiotics for the Treatment of Pneumonia

Abstract

In the last years, the presence of multidrug-resistant (MDR) Gram-negative (like Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii) and Gram-positive bacteria (mostly methicillin-resistant Staphylococcus aureus) was worldwide reported, limiting the options for an effective antibiotic therapy. For these reasons, inappropriate antimicrobial therapy and delayed prescription can lead to an unfavorable outcome, especially in patients with pneumonia. New antibiotics approved belong to classes of antimicrobials, like beta-lactams with or without beta-lactamase inhibitors, aminoglycosides, oxazolidinones, quinolones, and tetracyclines, or based on new mechanisms of action. These new compounds show many advantages, including a broad spectrum of activity against MDR pathogens, good lung penetration, safety and tolerability, and finally the possibility of intravenous and/or oral formulations. However, the new antibiotics under development represent an important possible armamentarium against difficult-to-treat strains. The safety and clinical efficacy of these future drugs should be tested in clinical practice. In this review, there are reported characteristics of newly approved antibiotics that represent potential future options for the treatment of respiratory tract infections, including those caused by multidrug-resistant bacteria. Finally, the characteristics of the drugs under development are briefly reported.

Multidrug-resistant Acinetobacter baumannii infections in COVID-19 patients hospitalized in intensive care unit

“…Finally, overcrowded wards, shortages of professionals with appropriate training in infection control procedures, and possible decreased laboratory ability to detect MDR carriage are potentially considered risk factors of MDR spread after the COVID-19 outbreak [ 19 , 20 ]. Then, it will be crucial to continue monitoring rates of MDR infections and implementing measures of infection control and antimicrobial stewardship [ 21 – 23 ].…”

Novel Therapeutic Trends in Pneumonia: Antibiotics and Mesenchymal Stem Cells

“…Furthermore, fluoroquinolones have been associated with adverse side effects, prompting the United States Food and Drug Administration to suggest that they be reserved for patients with no other treatment options [14,15]. High rates of treatment failure caused by inadequate antibiotic treatments have led to increased mortality and morbidity as well as longer hospital stays, highlighting the need for newer effective antibiotics [11]. These new antibiotics may address deficits in current antimicrobial drugs, with an ability to cover both typical, atypical, and resistant pathogens [7,16].…”

“…In a multicenter randomized control phase III trial (LEAP 1), IV-to-oral lefamulin was noninferior to IV-to-oral moxifloxacin in early clinical response (87.3% vs. 90.2% respectively, difference -2.9%, 95% CI -8.5 to 2.8) [21]. In a LEAP 2 trial, early clinical [11,[25][26][27] Protection against several imipenem-resistant bacteria MRSA: methicillin-resistant S. aureus; ELF: epithelial lining fluid response rates were 90.8% for oral lefamulin and 90.8% for oral moxifloxacin (difference 0.1%, 1-sided 97.5% CI, -4.4% to ∞) [21]. The most frequently reported treatmentemergent adverse events were gastrointestinal, (diarrhea 12.2% in lefamulin, 1.1% in moxifloxacin; nausea 5.2% in lefamulin and 1.9% in moxifloxacin) [21].…”

“…With the significant global health burden that pneumonia poses, it is essential to improve therapeutic and management strategies [10]. Although there are many treatments available, including antibiotics, corticosteroids, breathing treatments, and oxygen therapy, the increasing emergence of antibiotic resistant bacterial strains limits options for effective antibiotic use [3,10,11]. Furthermore, approximately 14-35% of hospitalized CAP patients die despite appropriate antibiotic treatments [12].…”

Editorial: Spotlight on the Relationship Between Sepsis and Infection: From Mechanisms to Therapy

“…Recently, new drugs for the treatment of severe infections have been approved but their role in clinical practice needs to be focused (11)(12)(13)(14)(15). As mentioned previously, knowledge of mechanisms related to progression from sepsis to septic shock and adequate management of patients, including choice and dosages of antimicrobials, prove crucial to improving the outcome of septic patients (16).…”