[Multidrug resistance and new anti-infective agents].

Multidrug-resistant pathogens are among the greatest global health threats. Among Gram-negative pathogens, the worldwide rise in carbapenem resistance is of particular clinical significance; among Gram-positive pathogens, methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci are of primary concern. Resistance mechanisms include changes in penicillin-binding proteins, enzymatic inactivation by β‑lactamases, porin modifications, and efflux pumps. Targeted therapy for infections caused by multidrug-resistant pathogens requires knowledge of the resistance mechanism and a phenotypic antibiotic susceptibility profile. New β‑lactam/β-lactamase inhibitor combinations have largely replaced older therapeutic approaches such as colistin for infections caused by multidrug-resistant Gram-negative pathogens due to their superior efficacy and tolerability. The recently published first German S3 guideline, "Antibiotic Therapy for Severe Infections Caused by Multidrug-Resistant Bacteria," provides practice-oriented treatment recommendations for infections caused by multidrug-resistant pathogens.