Novel agents in development for the treatment of resistant Gram-negative infections.

IF 4.2 2区医学 Q1 INFECTIOUS DISEASES

Expert Review of Anti-infective Therapy Pub Date : 2024-09-18 DOI:10.1080/14787210.2024.2407068

Matteo Bassetti,Barbara Larosa,Antonio Vena,Daniele Roberto Giacobbe

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引用次数: 0

Abstract

INTRODUCTION Several novel agents are in advanced stages of clinical development, potentially expanding our treatment options against third- and fourth-generation cephalosporin-resistant and carbapenem-resistant Gram-negative bacteria (GNB), including those pathogens for which the current number of effective treatments is limited. AREAS COVERED This review focuses on agents that have completed or ongoing phase-3 studies. A PubMed search was conducted up to 31 May 2024. EXPERT OPINION Novel agents in late-stage clinical development belong to the β-lactam or β-lactam/β-lactamase inhibitor combinations class and display variable antimicrobial activity depending on the specific β-lactamases expressed by GNB, particularly carbapenemases. While many of these novel agents demonstrate in vitro activity against carbapenem-resistant GNB, their efficacy has mainly been evaluated in phase-3 randomized controlled trials (RCT) for infections caused by carbapenem-susceptible GNB. Although evidence from real-world observational studies is generally less robust than that from RCT, it could be crucial for updating clinical guidelines on treating carbapenem-resistant GNB with these new agents in the absence of dedicated RCT.

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正在开发用于治疗耐药性革兰氏阴性菌感染的新型制剂。

简介几种新型制剂正处于临床开发的后期阶段，有可能扩大我们对第三代和第四代头孢菌素耐药和碳青霉烯耐药革兰氏阴性菌（GNB）的治疗选择，包括那些目前有效治疗方法数量有限的病原体。专家观点处于后期临床开发阶段的新型药物属于β-内酰胺或β-内酰胺/β-内酰胺酶抑制剂组合类，根据 GNB 表达的特定β-内酰胺酶（尤其是碳青霉烯酶）的不同而显示出不同的抗菌活性。虽然这些新型制剂中的许多对耐碳青霉烯类的 GNB 具有体外活性，但其疗效主要是在第三阶段随机对照试验（RCT）中对由碳青霉烯类易感 GNB 引起的感染进行评估的。虽然真实世界观察性研究的证据通常不如随机对照试验的证据有力，但在没有专门的随机对照试验的情况下，这些证据对于更新使用这些新药治疗耐碳青霉烯类 GNB 的临床指南至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Anti-infective Therapy 医学-药学

CiteScore

11.20

自引率

0.00%

发文量

审稿时长

4-8 weeks

期刊介绍： Expert Review of Anti-Infective Therapy (ISSN 1478-7210) provides expert reviews on therapeutics and diagnostics in the treatment of infectious disease. Coverage includes antibiotics, drug resistance, drug therapy, infectious disease medicine, antibacterial, antimicrobial, antifungal and antiviral approaches, and diagnostic tests.