Novel beta-lactam antibiotics and inhibitor combinations.

BACKGROUND: beta-Lactam antibiotics are the most used antibacterial agents in clinical practice, but the development of resistance poses some questions about their future leading to an urgent requirement for new compounds. Specifically, beta-lactamases represent the commonest single cause of bacterial resistance to beta-lactam antibiotics. Numerous chromosomal and plasmid-mediated types are known and classified on the basis of their structure. Among them, extended-spectrum beta-lactamases (ESBLs) and AmpC beta-lactamase can confer broad-spectrum antibiotic resistance to ureidopenicillins, third-generation cephalosporins and aztreonam, posing unique therapeutic challenges. Furthermore, the spreading emergence of carbapenemases is a significant threat to the management of nosocomial infections.

OBJECTIVE: To review characteristics of new drugs for beta-lactam resistance.

METHODS: We reviewed the principal characteristics of the new drugs studied for overcoming the emergence of beta-lactam resistance among Gram-negative and Gram-positive pathogens.

RESULTS/CONCLUSIONS: We included in our review new beta-lactamase inhibitors (Ro 48-1220), non-beta-lactam compounds (NXL-104), new oxapenenems (AM-112, -113, -114, -115) and penems (faropenem), new cephalosporins (ceftobiprole and ceftaroline) and new carbapenems (doripenem).