Infectious Diseases Division, Santa Maria Misercordia Hospital, Udine, Italy.
Ann Clin Microbiol Antimicrob. 2013 Aug 28;12:22. doi: 10.1186/1476-0711-12-22.
Bacterial resistance to antibiotics is growing up day by day in both community and hospital setting, with a significant impact on the mortality and morbidity rates and the financial burden that is associated. In the last two decades multi drug resistant microorganisms (both hospital- and community-acquired) challenged the scientific groups into developing new antimicrobial compounds that can provide safety in use according to the new regulation, good efficacy patterns, and low resistance profile. In this review we made an evaluation of present data regarding the new classes and the new molecules from already existing classes of antibiotics and the ongoing trends in antimicrobial development. Infectious Diseases Society of America (IDSA) supported a proGram, called "the '10 × ´20' initiative", to develop ten new systemic antibacterial drugs within 2020. The microorganisms mainly involved in the resistance process, so called the ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumanii, Pseudomonas aeruginosa, and enterobacteriaceae) were the main targets. In the era of antimicrobial resistance the new antimicrobial agents like fifth generation cephalosporins, carbapenems, monobactams, β-lactamases inhibitors, aminoglycosides, quinolones, oxazolidones, glycopeptides, and tetracyclines active against Gram-positive pathogens, like vancomycin-resistant S. aureus (VRSA) and MRSA, penicillin-resistant streptococci, and vancomycin resistant Enterococcus (VRE) but also against highly resistant Gram-negative organisms are more than welcome. Of these compounds some are already approved by official agencies, some are still in study, but the need of new antibiotics still does not cover the increasing prevalence of antibiotic-resistant bacterial infections. Therefore the management of antimicrobial resistance should also include fostering coordinated actions by all stakeholders, creating policy guidance, support for surveillance and technical assistance.
细菌对抗生素的耐药性在社区和医院环境中日渐严重，对死亡率、发病率和相关经济负担都有重大影响。在过去二十年中，多药耐药微生物（包括医院获得性和社区获得性）促使科研团队开发新的抗菌化合物，这些化合物需要根据新的规定确保使用安全、具有良好的疗效模式和低耐药性。在这篇综述中，我们评估了现有数据，涉及新类别和现有抗生素类别中的新分子，以及抗菌药物开发的持续趋势。美国传染病学会 (IDSA) 支持一项名为“‘10×20’倡议”的计划，旨在 2020 年内开发十种新的全身抗菌药物。主要涉及耐药过程的微生物，即所谓的 ESKAPE 病原体（屎肠球菌、金黄色葡萄球菌、肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌和肠杆菌科）是主要目标。在抗菌药物耐药时代，新的抗菌药物如第五代头孢菌素、碳青霉烯类、单环β-内酰胺类、β-内酰胺酶抑制剂、氨基糖苷类、喹诺酮类、恶唑烷酮类、糖肽类和四环素类对革兰阳性病原体（如耐万古霉素金黄色葡萄球菌（VRSA）和耐甲氧西林金黄色葡萄球菌（MRSA）、青霉素耐药性链球菌和耐万古霉素肠球菌（VRE））具有活性，也对高度耐药的革兰氏阴性菌有效，受到广泛欢迎。这些化合物中有一些已经得到官方机构的批准，有一些仍在研究中，但新抗生素的需求仍然无法满足日益增多的抗生素耐药性细菌感染。因此，抗菌药物耐药性的管理还应包括促进所有利益相关者的协调行动，制定政策指导，支持监测和技术援助。
