Management of severe infections by multi-resistant Gram-negative bacteria in critically ill patients.

Infections caused by multi-resistant Gram-negative bacilli (MDR-GNB) are currently one of the main public health problems worldwide. Various mechanisms such as altered permeability, efflux pumps, or the appearance of inactivating enzymes (β-lactamases or carbapenemases, among others) cause these bacteria to develop resistance to many of the traditional therapeutic options. Since 2015, new broad-spectrum antibiotics have been incorporated, transforming the treatment of infections caused by MDR-GNB. This article, with an eminently practical focus, aims to review and update the diagnosis and treatment of infections caused by MDR-GNB in critically ill patients, attempting to position the use of new antibiotics both in targeted and empirical, without forgetting the crucial role of infection control in combating this health threat.