Expert Review of Anti-infective Therapy最新文献

{"title":"Effective antimicrobial therapies needed for treatment of severe infections in African newborns.","authors":"Pui-Ying Iroh Tam, Adrie Bekker, Julia Anna Bielicki, Olufunke Bolaji, Gwendoline Chimhini, Ziyaad Dangor, Felicity Fitzgerald, Nelesh Govender, Sandi Holgate, Gugulabatembunamahlubi Tj Kali, Uduak Okomo, Tochi Okwor, Charlene Rodrigues, Sithembiso Velaphi, Andrew Whitelaw, Angela Dramowski","doi":"10.1080/14787210.2025.2484281","DOIUrl":"10.1080/14787210.2025.2484281","url":null,"abstract":"","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"243-246"},"PeriodicalIF":4.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gram-positive infections in special populations. Expert view on the role of dalbavancin.","authors":"Beatriz Sobrino, Sonia Luque, Eneritz Velasco-Arnaiz, Rubén Lovatti González, José Luis Del Pozo","doi":"10.1080/14787210.2025.2477196","DOIUrl":"10.1080/14787210.2025.2477196","url":null,"abstract":"<p><strong>Introduction: </strong>This review considers special populations as those patients for whom Gram-positive infections are particularly challenging to treat. We examine the potential benefits of dalbavancin in these patients.</p><p><strong>Areas covered: </strong>We focus on patients with renal impairment, hepatic failure or obesity, and, also, pediatric patients, elderly patients and socially vulnerable individuals. Five independent experts conducted exhaustive literature searches on PubMed. Papers were selected for inclusion according to their relevance to the topic. For each special population, we outline the most significant characteristics for infection management, describing the challenges of the most frequent Gram-positive infections, and reviewing the potential role of dalbavancin.</p><p><strong>Expert opinion: </strong>Dalbavancin may be a valid alternative to overcome the difficulties of infection management in these populations. We hope our insights will prove useful for patient-centered care. A long half-life, evidence-based efficacy and good safety profile make dalbavancin an adequate option, particularly for patients for whom oral treatment or continued IV access may be challenging, or those for whom hospital stay is more impactful. [Figure: see text].</p>","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"265-275"},"PeriodicalIF":4.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrence of group B streptococcal infections in infants: a systematic review.","authors":"Francesca Miselli, Alessandra Boncompagni, Riccardo Cuoghi Costantini, Tommaso Zini, Luca Bedetti, Martina Buttera, Lucia Corso, Roberta Creti, Isotta Guidotti, Cecilia Rossi, Eugenio Spaggiari, Licia Lugli, Alberto Berardi","doi":"10.1080/14787210.2025.2474569","DOIUrl":"10.1080/14787210.2025.2474569","url":null,"abstract":"<p><strong>Introduction: </strong>Group-B Streptococcus(GBS) infections may rarely recur after antibiotic treatment. We aimed to fill existing gaps on epidemiology, clinical features, and outcomes of GBS recurrences.</p><p><strong>Methods: </strong>A systematic search of PubMed and Embase was conducted, covering the period until 1 July 2024. The demographics, clinical characteristics, treatment, and outcomes of infants withGBS recurrence were analyzed. Recurrence was defined as > 1 episode of invasiveGBS infection (positive blood and/or cerebrospinal fluid culture), occurring after the completion of treatment for the initial episode.</p><p><strong>Results: </strong>Among the 213 recurrences, 146 reported individual data and were included in the analysis. GBS recurrences developed shortly after the completion of antibiotic treatment for the initial infection (median = 10 days 95%CI 6.0-18.8). Most infants were preterm (63.5%) and had received an adequately long course of antibiotics for the initial infection (median = 13 days, 95%CI 10-14). Serotype III waspredominant. Breast milk yielded GBS in most samples cultured (41/62, 66%); 5/15 (33%) infants who discontinued breastfeeding after recurrence had further GBS recurrence. Case fatalities were 3.7%.</p><p><strong>Conclusions: </strong>Preterm birth is closely associated with GBS recurrences. Adequately long courses of antibiotics or withdrawal of breast milk may not be useful measures to prevent recurrences.</p>","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"305-314"},"PeriodicalIF":4.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Past, present, and future perspectives on aztreonam and avibactam.","authors":"Karen Bush","doi":"10.1080/14787210.2025.2473047","DOIUrl":"10.1080/14787210.2025.2473047","url":null,"abstract":"<p><strong>Introduction: </strong>Aztreonam is a monobactam antibiotic approved in 1986 to treat infections caused by aerobic Gram-negative bacteria, but, together with cephalosporins, lost clinical utility due to the emergence of extended-spectrum β-lactamases (ESBLs) and novel (serine) carbapenemases. Avibactam was the first in a novel non-β-lactam β-lactamase inhibitor class to effectively inhibit these enzymes. It has been approved in combination with ceftazidime to treat Gram-negative infections caused by bacteria that produce AmpC, ESBLs and serine carbapenemases, and with aztreonam to treat patients infected with metallo-β-lactamase-producing enteric bacteria. Combinations of avibactam with ceftazidime and/or aztreonam have been used successfully to treat enteric pathogens producing multiple classes of β-lactamases.</p><p><strong>Areas covered: </strong>Development of aztreonam, avibactam, and avibactam combinations are placed into a historical perspective, based on both preclinical and clinical data. A search of MEDLINE (Ovid) was used to identify relevant literature.</p><p><strong>Expert opinion: </strong>Avibactam combined with ceftazidime and aztreonam in either dual or triple combinations provides the opportunity to treat previously untreatable Gram-negative infections that produce multiple β-lactamases. Aztreonam combinations should be particularly attractive, due to stability to metallo-β-lactamase hydrolysis and its safety advantage in treating penicillin-allergic patients. Other inhibitor combinations in development may challenge these combinations.</p>","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"277-290"},"PeriodicalIF":4.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting the limit to ceftriaxone's use in gonorrhea treatment: impending resistance and logistical challenges.","authors":"Susannah F Vanderpool, Nardine Karam, Margaret R Hammerschlag","doi":"10.1080/14787210.2025.2499471","DOIUrl":"https://doi.org/10.1080/14787210.2025.2499471","url":null,"abstract":"<p><strong>Introduction: </strong>The increasing prevalence of antimicrobial resistance in Neisseria gonorrhoeae threatens the efficacy of ceftriaxone, the last widely effective treatment for gonorrhea. Resistance mechanisms challenge the adequacy of current dosing strategies and minimum inhibitory concentration (MIC) thresholds, with treatment failures documented at MICs as low as 0.125 mcg/mL. Limited clinical and pharmacodynamic data complicate efforts to define optimal dosing and resistance breakpoints.</p><p><strong>Areas covered: </strong>This review examines the evolution of ceftriaxone dosing recommendations in response to resistance trends, explores the genetic and pharmacokinetic factors driving reduced susceptibility, and critically evaluates the CDC's MIC 'alert value' of 0.125 mcg/mL. Surveillance data are analyzed alongside pharmacokinetic/pharmacodynamic (PK/PD) models, including Monte Carlo simulations and hollow fiber infection models (HFIM). Practical challenges, including injection site tolerability, lidocaine safety, and dosing limits for intramuscular administration, are reviewed.</p><p><strong>Expert opinion: </strong>Current PK/PD data and IV tolerability studies support ceftriaxone dose escalation up to 3.5 g IM as a feasible outpatient limit for strains with MICs up to 0.5 mcg/mL. However, the MIC at which even high-dose regimens fail remains unknown. Urgent priorities include validating higher doses through clinical pharmacokinetic and outcomes studies, refining MIC thresholds by anatomical site, and evaluating novel agents for reliable pharyngeal eradication.</p>","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"1-8"},"PeriodicalIF":4.2,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Critical reappraisal of current issues for improving the proper clinical use of the incoming beta-lactam/beta-lactamase inhibitor combinations of tomorrow.","authors":"Milo Gatti, Federico Pea","doi":"10.1080/14787210.2025.2493077","DOIUrl":"https://doi.org/10.1080/14787210.2025.2493077","url":null,"abstract":"<p><strong>Introduction: </strong>Although different novel beta-lactam/beta-lactamase inhibitor combinations (BL/BLIc) were recently licensed, resistance occurrence have been reported up to 15% of Gram-negative pathogens. For this reason, novel BL/BLIc of tomorrow will be released for managing difficult-to-treat resistance (DTR) Gram-negative infections.</p><p><strong>Areas covered: </strong>This review provides a critical reappraisal of current issues for improving the proper clinical use of the novel BL/BLIc of tomorrow. A literature search was performed on PubMed-MEDLINE (until December 2024) for retrieving available studies on cefepime-enmetazobactam, sulbactam-durlobactam, and cefepime-taniborbactam. Four different main areas were discussed according to available evidence: 1) translating findings coming from the randomized clinical trials into the real-world clinical practice; 2) defining the optimal joint pharmacokinetic/pharmacodynamic (PK/PD) target; 3) identifying proper dosing schedules in patients with renal dysfunction; 4) attributing proper relevance to the epithelial lining fluid (ELF) penetration rate in defining optimal dosing schedule for treating pneumonia.</p><p><strong>Expert opinion: </strong>Overall, old habits die hard and issues retrieved with licensed beta-lactams emerged also with novel BL/BLIc of tomorrow, potentially affecting their efficacy when used in real-world practice. Adopting appropriate corrective measures for overcoming these issues might increase the likelihood of preserving their efficacy in the future by minimizing the propensity risk of resistance development.</p>","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"1-11"},"PeriodicalIF":4.2,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of clinical outcomes of antibiotics used for <i>Staphylococcus aureus</i> bacteremia in pediatric patients.","authors":"Ömer Güneş, Saliha Kanık-Yüksek, Aylin Kayalı-Akyol, Özhan Akyol, Ahmet Yasin Güney, Fatih Üçkardeş, Aysun Yahşi, Seval Özen, Tuğba Erat, Belgin Gülhan, Gülsüm İclal Bayhan, Aslınur Özkaya-Parlakay","doi":"10.1080/14787210.2025.2493075","DOIUrl":"https://doi.org/10.1080/14787210.2025.2493075","url":null,"abstract":"<p><strong>Background: </strong>This study aims to evaluate the risk factors, clinical features, and clinical outcomes among pediatric hospitalized patients receiving treatment for <i>Staphylococcus aureus</i> bacteremia and compare the effects of antibiotics used in the treatment on clinical outcomes.</p><p><strong>Research design and methods: </strong>This single-center retrospective study included patients aged between 1 month and 18 years who received treatment for Staphylococcus aureus bacteremia (SAB) betweenSeptember 2019 and September 2022.</p><p><strong>Results: </strong>SAB was detected in 95 pediatric patients. In MRSA bacteremias, no difference in clinical outcomes was found between patients receiving vancomycin or teicoplanin. In MSSA bacteremias, the recurrence rate of SAB was 0% in the penicillin group and 23.5% in the cephalosporin group. The median duration of bacteremia-related hospital stay (10 vs. 14 days), and the median duration of bacteremia (2 vs. 3 days) were shorter in the ampicillin-sulbactam group than in the piperacillin-tazobactam group (<i>p</i> = 0.016, and <i>p</i> = 0.050, respectively).</p><p><strong>Conclusions: </strong>Teicoplanin was found to have similar clinical outcomes to vancomycin in treating MRSA bacteremia. In addition, ampicillin sulbactam was found to have better clinical outcomes than other antibiotics in treating MSSA bacteremia. Teicoplanin and ampicillin sulbactam may be considered as a choice in the treatment of pediatric SAB.</p>","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"1-8"},"PeriodicalIF":4.2,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current access, availability and use of antibiotics in primary care among key low- and middle-income countries and the policy implications.","authors":"Zikria Saleem, Biset Asrade Mekonnen, Ebiowei Samuel Orubu, Md Ariful Islam, Thuy Thi Phuong Nguyen, Chukwuemeka Michael Ubaka, Deus Buma, Nga Do Thi Thuy, Yashasvi Sant, Tiyani Milta Sono, Tomasz Bochenek, Aubrey C Kalungia, Saad Abdullah, Nenad Miljković, Eugene Yeika, Loveline Lum Niba, George Akafity, Israel Abebrese Sefah, Sylvia A Opanga, Freddy Eric Kitutu, Felix Khuluza, Trust Zaranyika, Ayuska Parajuli, Omeed Darweesh, Salequl Islam, Santosh Kumar, Hellen Nabayiga, Ammar Abdulrahman Jairoun, Audrey Chigome, Olayinka Ogunleye, Joseph Fadare, Amos Massele, Aislinn Cook, Ana Golić Jelić, Isabella Piassi Dias Godói, Amani Phillip, Johanna C Meyer, Elisa Funiciello, Giulia Lorenzetti, Amanj Kurdi, Abdul Haseeb, Catrin E Moore, Stephen M Campbell, Brian Godman, Mike Sharland","doi":"10.1080/14787210.2025.2477198","DOIUrl":"10.1080/14787210.2025.2477198","url":null,"abstract":"<p><strong>Introduction: </strong>Antimicrobial resistance (AMR) poses a significant threat, particularly in low- and middle-income countries (LMICs), exacerbated by inappropriate antibiotic use, access to quality antibiotics and weak antimicrobial stewardship (AMS). There is a need to review current evidence on antibiotic use, access, and AMR, in primary care across key countries.</p><p><strong>Areas covered: </strong>This narrative review analyzes publications from 2018 to 2024 regarding access, availability, and use of appropriate antibiotics.</p><p><strong>Expert opinion: </strong>There were very few studies focussing on a lack of access to antibiotics in primary care. However, there was considerable evidence of high rates of inappropriate antibiotic use, including Watch antibiotics, typically for minor infections, across studied countries exacerbated by patient demand. The high costs of antibiotics in a number of LMICs impact on their use, resulting in short courses and sharing of antibiotics. This can contribute to AMR alongside the use of substandard and falsified antibiotics. Overall, limited implementation of national action plans, insufficient resources, and knowledge gaps affects sustainable development goals to provide routine access to safe, effective, and appropriate antibiotics.</p><p><strong>Conclusions: </strong>There is a clear need to focus health policy on the optimal use of essential AWaRe antibiotics in primary care settings to reduce AMR in LMICs.</p>","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"1-42"},"PeriodicalIF":4.2,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building upon the core elements of antifungal stewardship: practical recommendations for effective antifungal stewardship in resource-limited settings.","authors":"Arunaloke Chakrabarti, Rita Oladele, Elizabeth Hermsen, Maria Lavinea Novis de Figueiredo, Patricia Muñoz, Melissa Johnson","doi":"10.1080/14787210.2025.2479011","DOIUrl":"10.1080/14787210.2025.2479011","url":null,"abstract":"<p><strong>Introduction: </strong>Despite the crucial importance of effective AFS in resource-limited settings, such settings remain comparatively underserved and underrepresented in terms of resource-setting-specific guidance and research. Further practical contextualization and application of current AFS best practices is thus necessary.</p><p><strong>Areas covered: </strong>A panel of leading experts from diverse countries (India, Nigeria, Spain, and the US) was brought together to provide recommendations for practical and effective implementation of AFS in resource-limited settings. We have adapted and contextualized the Centers for Disease Control and Prevention's (CDC) seven core elements and the Mycoses Study Group Education and Research Consortium's (MSGERC) recommendations for facilities in resource-limited settings through a resource-stratified approach. Where relevant to facilities based on their context and respective resources across multiple dimensions, facilities may choose to prioritize certain recommendations that may be more immediately actionable before implementing others.</p><p><strong>Expert opinion: </strong>We recommend future studies to examine the efficacy, cost-effectiveness, and practicality of our recommendations in resource-limited settings to enable them to effectively prioritize, channel or gradually increase resource capacity at hand. AFS interventions should be integrated within a larger systemic framework (e.g. city, state, national, regional, international) with collaboration among institutional leadership, ID specialists, healthcare workers, public, policymakers, and pharmaceutical industry.</p>","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"1-19"},"PeriodicalIF":4.2,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143614087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of methicillin-resistant <i>Staphylococcus aureus</i> bloodstream infections: a comprehensive narrative review of available evidence focusing on current controversies and the challenges ahead.","authors":"Alberto Enrico Maraolo, Milo Gatti, Luigi Principe, Andrea Marino, Giuseppe Pipitone, Gennaro De Pascale, Giancarlo Ceccarelli","doi":"10.1080/14787210.2025.2487163","DOIUrl":"10.1080/14787210.2025.2487163","url":null,"abstract":"<p><strong>Introduction: </strong>Bloodstream infections (BSIs) caused by <i>Staphylococcus aureus</i> are common worldwide, representing one of the most relevant issues in clinical infectious diseases practice. In particular, BSIs by methicillin-resistant <i>S. aureus</i> (MRSA-BSI) are still today a challenge since mortality burden remains elevated although decades of research.</p><p><strong>Areas covered: </strong>The following topics regarding MRSA-BSI were reviewed and discussed by resorting to best available evidence retrieved from PubMed/MEDLINE up to October 2024: i) epidemiology; ii) microbiology; iii) classification, with a focus on complicated and not complicated forms; iv) the structured approach to the patient; v) pharmacokinetics and pharmacodynamics of the main antimicrobial options; vi) controversies regarding the best therapeutic approach.</p><p><strong>Expert opinion: </strong>Despite ongoing efforts to better stratify and manage MRSA-BSI, there is no universally accepted classification system accurately distinguishing between uncomplicated/low risk and complicated/high risk forms. Biomarkers such as interleukin(IL)-10 hold promise in order to enable a more precise stratification, premise for an appropriate treatment plan. There is a theoretical rationale for implementing a combination therapy including a beta-lactam agent upfront, especially for patients considered at higher risk of unfavorable outcomes, but further data are necessary, and the same applies to newer adjuvants. Novel microbiological techniques may help in guiding antimicrobial duration.</p>","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"1-26"},"PeriodicalIF":4.2,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}