Present status of drug resistant gram negative bacilli and treatment strategies

Infections caused by drug resistant gram-negative bacilli have raised particular concern.There are multiple mechanisms promoting resistance against same antibiotic or a single mechanism affecting multiple antibiotics.Infections caused by extended-spectrum β-lactamase(ESBL)-producing or carbapenemase-producing Enterobacteriaceae and multi-drug resistant strains of nonfermenting glucose gram-negative bacteria including Pseudomonas aeruginosa,Acinetobacter baumannii are increasingly being reported worldwide.Treatment strategies include using some recently licensed agents with activity against gram-negative bacteria such as tigecycline and doripenem.Some old antibiotic classes such as aminoglycosides,colistin and sulbactam have a resurgence of use in recent years.The importance of rational antibiotic therapy and control of the spread of resistant strains needs to be emphasized.