Contemporary resistance trends and mechanisms for the old antibiotics colistin, temocillin, fosfomycin, mecillinam and nitrofurantoin

摘要: Recently there has been a renewed interest in reviving older antimicrobial agents, particularly those with activity against multidrug-resistant Gram-negative bacilli. Because many such antimicrobials are not licensed all countries, is paucity of international surveillance data, and none these agents part any resistance on the level EU. Some used lower urinary tract infection, whereas most available supranational data pertain to severe infections as bloodstream infections. Among old interesting compounds from clinical perspective two intravenous colistin temocillin, oral pivmecillinam nitrofurantoin, fosfomycin, which both for use. The target microorganisms Enterobacteriaceae, although also good Pseudomonas aeruginosa Acinetobacter species. Recent European point approximately 5% general among Klebsiella pneumoniae, carbapenemase-producing Enterobacteriaceae may be up 15% 20% some settings. Temocillin stable extended-spectrum β-lactamase-producing carbapenemase producers, but low-level uncommon β-lactamase high-level always seen OXA-48 group carbapenemases. Fosfomycin rare areas limited use increasing countries higher usage. Resistance levels mecillinam nitrofurantoin generally low EU supporting treatment efficacy strains few. Systematic above-mentioned will important,