Meritxell Salvadó Soro, from the Mollet Hospital Internal Medicine Service; and Pedro Linares Mondejar, from the Infectious Diseases Service of the University Hospital of La Coruña.
Treatment of infections antibiotic resistant bacteria is one of the main themes of all editions of Infectious Diseases Conference organized by the Spanish Society of Internal Medicine, which takes place this Friday. In this twelfth appointment, Meritxell Salvadó Soro from the Department of Internal Medicine of Hospital Mollet (Barcelona) and Pedro Llinares Mondéjar from the Department of Infectious Diseases of the University Hospital of La Coruña were responsible for presenting the latest drugs available to deal with bacteria and ask for a higher funding to improve its availability.
“If you look at the data for the last five years, resistance has not increased to methicillin, penicillin and vancomycin; but to count on affected patientsbecause there is a growing population of infected and older people,” Linares said during his presentation, “News in Antibiotic Treatment of Resistant Gram-Positive Cocci.”
Specifically, he pointed out drug tedizolid as an alternative to the most commonly used classic antibiotics against S. Aereus (vancomycin, teicoplanin, clindamycin, co-trimoxazole, etc.). This is a single-dose medication with “higher security, fewer interactions and shorter treatment time”. “In cases where linezolid is the drug of choice (such as renal failure, anemia or thrombocytopenia), tedizolid can be used,” he said.
Linares: “Most of these antibiotics are expensive and not financed by the National Health System (SNS)”
On the other hand, he also chose the use of dalbavancin and oritavancin instead of linezolid because they are “32 times more active against enterococci.” Among their advantages, he pointed out that they have very long half-lives and that in chronic infections “provide good security in terms of its effectiveness
In the same way he named ceftaroline and ceftobiproleboth antibiotics against gram-positive as they have synergistic studies against S. aureus, E. faecalis Y E. Faecium. “Its adverse effects are less and more than 71 percent success rate. They are a solution for severe pneumonia,” Linares pointed out, lamenting that many of the drugs he talked about are “dear” and they are not fully covered by the National Health System (NHS).
Antibiotic resistance, a “natural phenomenon”
For his part, Salvado pointed out that antibiotic resistance is a “natural phenomenon” which has been around for decades. However, it was not until 2001 that the World Health Organization (WHO) repeated this increasing resistance at a global level and it was only in 2012 that the definitions of what counts as resistance were established, multi-resistance, extreme resistance and panresistance.
“Over the last few years we have done a rational use of antibioticscreated policies to limit them, especially in animal husbandry, and developed new drugs of this type”, indicated the professional from the in-hospital service of the Molle Hospital at the beginning of his presentation “News in the antibiotic treatment of resistant gram-negative bacilli”.
Despite these efforts, however, there is still work to be done. According to attributable mortality for this reason it is believed that they can die 10 million people in 2050 due to antibiotic resistance.
Salvado: “New antibiotics cause fewer adverse effects, but require targeted treatment”
In addition, there are certain risk factors which increase the chances of the patient being multidrug resistant such as age, concomitant diseasesthe use of corticosteroids or hospitalization, among others.
For all these reasons, he wanted to list the following new antibiotics against resistant gram-negative bacilli: ceftolozane-tazobactam, ceftazidime-avibactam, murepavadine (new mechanism of action) or imipenem-relebactam, among others. “production fewer side effects than the classic drugs that we used to treat these infections, but we must keep in mind that they require targeted treatment“, he added.
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