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Indian J Med Microbiol. 2019 Jan-Mar;37(1):72-90. doi: 10.4103/ijmm.IJMM_19_215.

Colistin-sparing approaches with newer antimicrobials to treat carbapenem-resistant organisms: Current evidence and future prospects.

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Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India.
Department of Infectious Diseases, Global Hospital, Chennai, Tamil Nadu, India.
Department of Pediatrics, Kanchi Kamakoti Childs Trust Hospital, Chennai, Tamil Nadu, India.


Antimicrobial resistance is on the rise across the globe. Increasing incidence of infections due to carbapenem resistance organisms is becoming difficult to treat, due to the limited availability of therapeutic agents. Very few agents such as colistin, fosfomycin, tigecycline and minocycline are widely used, despite its toxicity. However, with the availability of novel antimicrobials, beta-lactam/beta-lactamase inhibitor-based and non-beta-lactam-based agents could be of great relief. This review covers three important aspects which include (i) current management of carbapenem-resistant infections, (ii) determination of specific types of carbapenemases produced by multidrug-resistant and extensively drug-resistant Gram-negative pathogens and (iii) the currently available novel beta-lactam/beta-lactamase inhibitors and non-beta-lactam-based agents' laboratory findings, clinical outcome and implications.


Antimicrobial resistance; India; NDM; Oxa48-like; colistin; newer antimicrobials

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