Antimicrobial Resistance: The Big Picture

An Interview With CDC's Steven L. Solomon, MD

Laura A. Stokowski, RN, MS; Steven L. Solomon, MD


September 16, 2013

Editorial Collaboration

Medscape &

In This Article

The Treatment and Testing Pipeline

Medscape: What is the current progress of new antibiotic development?

Dr. Solomon: The treatment options, particularly for infections caused by gram-negative pathogens, are becoming very limited. Healthcare-associated infections caused by Enterobacteriaceae, Pseudomonas aeruginosa, and Acinetobacter are the most serious and difficult to treat, especially infections caused by pan-resistant or nearly pan-resistant gram-negative microorganisms. Some Enterobacteriaceae, for example, are resistant to nearly all penicillins and cephalosporins, which leaves antibiotics from the carbapenem family as treatments of last resort. Unfortunately, resistance is also developing to these drugs.

We will never be able to completely halt the development of resistance in microorganisms because it is a natural evolutionary process. The best we can hope for is to slow the rate of resistance so that the development of new antibiotics stays one step ahead of the bacteria. We will always need new antibiotics to keep up with the development of resistance. Unfortunately, very few new antibiotics are in the pipeline.

Medscape: Is the ability to rapidly screen and test patients still a significant obstacle in prevention and antibiotic stewardship efforts?

Dr. Solomon: Yes, especially for some of the most urgent pathogens, such asCRE. We need to be able to identify patients who are colonized with CRE to implement infection control around those patients to prevent transmission to others. We need new, better, and more rapid diagnostics for such purposes. We need new diagnostic tests for antimicrobial susceptibility, and new molecular techniques hold promise in that area. We expect to see new tests coming to market that will more effectively identify multidrug-resistant gram-negative bacteria.


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