![]() ![]() Temiacillin, a beta-lactam antibiotic effective against Gram-negative bacteria that is only licenced in Belgium and the United Kingdom, is also worth mentioning alongside these novel medicines. Plazomicin, eravacycline, cefiderocol, ceftazidime/avibactam, ceftolozane/tazobactam, meropenem/va are examples of new antibiotics with predominant activity against Gram-negative bacteria that have been approved by the US Food and Drug Administration (FDA) and the European Medical Agency (EMA). These beta-lactamases can be classified into four molecular classes:Ĭlass A (for example, KPCs that confer resistance to cephalosporins and to all carbapenems, and extended-spectrum beta-lactamases (ESBLs) that confer resistance to cephalosporins)Ĭlass B (metallo-beta-lactamases (MBLs), such as NDM, VIM, and IMP, which can lead to resistance to all carbapenems except monobactam)Ĭlass C (for example, AmpC (mostly chromosomal but can also be plasmidal), which confer resistance to cephalosporins)Ĭlass D (for example, OXAs that confer resistance mostly to carbapenems) ![]() Beta-lactam antibiotics-penicillins, cephalosporins, carbapenems, and to a lesser extent monobactams-are often the antibiotics of choice in the ICU, but they can be inactivated by beta-lactamase enzymes. Several multidrug-resistant Gram-negative bacteria, including carbapenem-resistant Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacterales, have been added to the World Health Organization’s latest list of high-priority pathogens. Gram-negative bacteria cause two-thirds of infections in intensive care units (ICUs), and antibiotic resistance among these bacteria is a serious issue.
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