Journal of Antimicrobial Chemotherapy, Vol 39, 1-6, Copyright © 1997 by The British Society for Antimicrobial Chemotherapy
F Baquero
The incidence of infections caused by multidrug-resistant Gram-positive
organisms is increasing despite advances in antibacterial therapy over the
last 20 years. As the pathogens causing these infections are frequently
resistant to most currently available antibacterials, they are extremely
difficult to treat. Problematic pathogens include strains of Streptococcus
pneumoniae resistant to beta-lactams and macrolides, viridans group
streptococci resistant to beta-lactams and aminoglycosides, enterococci
resistant to vancomycin and teicoplanin and highly resistant to penicillins
and aminoglycosides, and Staphylococcus aureus resistant to methicillin,
other beta-lactams, macrolides, lincosamides and aminoglycosides. Other
important pathogens include Streptococcus pyogenes resistant to macrolides
(and suspected to be resistant to penicillin), macrolide-resistant
streptococci of groups B, C, and G, coagulase-negative staphylococci
resistant to beta- lactams, aminoglycosides, macrolides, lincosamides and
glycopeptides, multiresistant strains of Listeria and Corynebacterium and
Gram- positive anaerobes, such as Peptostreptococcus and Clostridium,
resistant to penicillins and macrolides. Thus, there is an urgent need for
new antibacterial agents that are able to overcome multidrug- resistant
mechanisms. The novel semisynthetic injectable streptogramin
quinupristin/dalfopristin offers the prospect of effective treatment
against many of the above pathogens.
ORIGINAL ARTICLES
Gram-positive resistance: challenge for the development of new antibiotics
Departamento de Microbiologia, Ramon y Cajal Hospital, Madrid, Spain.
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