Treatment of Multidrug-resistant Gram-Negative Skin and Soft Tissue Infections

Jean-Francois Jabbour; Sima L. Sharara; Souha S. Kanj


Curr Opin Infect Dis. 2020;33(2):146-154. 

In This Article


MDR-GNB plays an important role in SSTIs in immunocompromised and at-risk patients. These infections are associated with high morbidity and prolonged hospital stay. Recently released drugs have shown potent activity against these MDR pathogens, however, their role in the treatment of SSTIs has not been shown in RCTs. In practice, their use has been based on in-vitro susceptibility data and efficacy data extrapolated from their efficacy in other infection sites. With the complexity of the molecular types of MDR-GNB, especially CRE, rapid diagnostic molecular studies are needed to guide therapy.

Various new agents show promise in the treatment of MDR-GNB SSTIs. Clear guidelines on choices of therapy and proper dosing for the directed therapy against MDR-GNB SSTIs are needed. Beyond antibiotic management, anecdotal reports of other modalities of treatment such a phage therapy, antimicrobial peptides, and antibiotic nanotherapy show promising results in the management of challenging MDR infections.