Current Therapeutic Approaches for Multidrug-Resistant and Extensively Drug-Resistant Infections.

The treatment of infections remains a challenge for physicians worldwide in the 21st century. The bacterium possesses a multitude of mechanisms to escape the human immune system. The consequences of infections on morbidity and mortality, as well on financial resources, remain dire. Furthermore, superinfections have also occurred during the COVID-19 pandemic. While prevention is important, the antibiotic armamentarium remains the most essential factor for the treatment of these infections. The main problem is the notorious resistance profile (including resistance to carbapenems and colistin) that this bacterium exhibits. While newer beta lactam/beta-lactamase inhibitors have entered clinical practice, with excellent results against various infections due to Enterobacteriaceae, their contribution against infections is almost absent. Hence, we have to resort to at least one of the following, sulbactam, polymyxins E or B, tigecycline or aminoglycosides, against multidrug-resistant (MDR) and extensively drug-resistant (XDR) infections. Furthermore, the notable addition of cefiderocol in the fight against infections represents a useful addition. We present herein the existing information from the last decade regarding therapeutic advances against MDR/XDR infections.