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Review
. 2019 Jun 28;8(7):934.
doi: 10.3390/jcm8070934.

Treatment Options for Colistin Resistant Klebsiella pneumoniae: Present and Future

Nicola Petrosillo  1 , Fabrizio Taglietti  2 , Guido Granata  3
Affiliations
Review

Treatment Options for Colistin Resistant Klebsiella pneumoniae: Present and Future

Nicola Petrosillo et al. J Clin Med. .

Abstract

Multidrug-resistant (MDR) Klebsiella pneumoniae represents an increasing threat to human health, causing difficult-to-treat infections with a high mortality rate. Since colistin is one of the few treatment options for carbapenem-resistant K. pneumoniae infections, colistin resistance represents a challenge due to the limited range of potentially available effective antimicrobials, including tigecycline, gentamicin, fosfomycin and ceftazidime/avibactam. Moreover, the choice of these antimicrobials depends on their pharmacokinetics/pharmacodynamics properties, the site of infection and the susceptibility profile of the isolated strain, and is sometimes hampered by side effects. This review describes the features of colistin resistance in K. pneumoniae and the characteristics of the currently available antimicrobials for colistin-resistant MDR K. pneumoniae, as well as the characteristics of novel antimicrobial options, such as the soon-to-be commercially available plazomicin and cefiderocol. Finally, we consider the future use of innovative therapeutic strategies in development, including bacteriophages therapy and monoclonal antibodies.

Keywords: Cefiderocol; Ceftazidime/Avibactam; Colistin; Colistin-resistant; Fosfomycin; Klebsiella pneumoniae; Plazomicin; Tigecyclin.

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Conflict of interest statement

N.P. received fees as speaker/scientific board from MSD, Pfizer, Angelini, Zambon, Johnson & Johnson, Shionogi, Becton & Dickinson, Cepheid; G.G. and F.T. declare no conflict of interest.

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