New Antimicrobials for Gram-Positive Sustained Infections: A Comprehensive Guide for Clinicians

Abstract

Antibiotic resistance is a public health problem with increasingly alarming data being reported. Gram-positive bacteria are among the protagonists of severe nosocomial and community infections. The objective of this review is to conduct an extensive examination of emerging treatments for Gram-positive infections including ceftobiprole, ceftaroline, dalbavancin, oritavancin, omadacycline, tedizolid, and delafloxacin. From a methodological standpoint, a comprehensive analysis on clinical trials, molecular structure, mechanism of action, microbiological targeting, clinical use, pharmacokinetic/pharmacodynamic features, and potential for therapeutic drug monitoring will be addressed. Each antibiotic paragraph is divided into specialized microbiological, clinical, and pharmacological sections, including detailed and appropriate tables. A better understanding of the latest promising advances in the field of therapeutic options could lead to the development of a better approach in managing antimicrobial therapy for multidrug-resistant Gram-positive pathogens, which increasingly needs to be better stratified and targeted.

Keywords: Gram-positive pathogens; PK/PD features; delafloxacin; lipoglycopeptides; novel anti-MRSA β-lactams; omadacycline; tedizolid.

Figure 1

Chemical structure depiction of ceftaroline fosamil.

Figure 2

Depiction of the chemical structure of ceftobiprole.

Figure 3

Depiction of the chemical structure of oritavancin.

Figure 4

Depiction of the chemical structure of dalbavancin.

Figure 5

Depiction of the chemical structure of omadacycline.

Figure 6

Depiction of the chemical structure of tedizolid.

Figure 7

Depiction of the chemical structure of delafloxacin.