What's new on the antimicrobial horizon?

The antimicrobial era is threatened by high levels of antibiotic resistance, the limited number and disparate availability of effective antibiotics against diverse bacterial species, and reduced involvement by the pharmaceutical industry in the development of new anti-infectives. For the treatment of resistant Gram-positive coccal infections, particularly methicillin-resistant staphylococcal infections, vancomycin has long been the mainstay antimicrobial agent due to its safety, durability against resistance, and lack of other approved alternatives. However, the efficacy and safety of vancomycin for the treatment of many serious infections has been called into question. Promising results from clinical trials suggest that five new antimicrobials could offer safe and effective alternatives to vancomycin. With regard to resistant Gram-negative infections, new carbapenems and some other options will be available. This paper reviews the safety and efficacy of these new antimicrobial agents against resistant bacterial pathogens.