New Antibiotics for Severe ICU-Aquired Bacterial Infections

Julien      Poissy; Eric      Senneville

doi:10.2174/187152611796504854

Abstract

Infection is a major cause of morbidity and mortality in intensive care units (ICU). The impact on prognostic of an inadequate antibiotic therapy is well established. The problem is due to the growing spread of resistant microorganisms, including both Gram-negative and Gram-positive pathogens, especially in the case of ICU-acquired infections. In this context, antibiotics with broad spectrum activity are usually required. Moreover, these antibiotics should reach high concentrations in tissues, especially in lungs, and should exert a bactericidal activity for the most severely ill patients, especially those with bloodstream infections. A frequent problem in clinical practice is the lack of data validating their use in the context of critically ill patients. In the present article, we review the newest antibiotics that could be of interest for severe ICU-acquired infections: tigecycline, moxifloxacine, the newer carbapenems, linezolide and daptomycine. We discuss their approved indications and identify the fields in which they could be used to treat infections acquired in the ICU.

Keywords: New antibiotics, severity, acquired infections, intensive care, ICU-acquired infections, linezolide and daptomycine, spectrum beta-lactamase-producing enterobacteriaceae (ESBLE), bloodstream infections, Haemophilus influenza, Nosocomial bloodstream infections, tetracyclineresistant isolates, Stenotrophomonas maltophilia, pharmacokinetic, alkaline phosphatase, tigecyclin, hemodialysis