ReviewPathogens (Basel, Switzerland)2025
Antimicrobial Treatment Options for Multidrug Resistant Gram-Negative Pathogens in Bone and Joint Infections.
Review in Pathogens (Basel, Switzerland), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Risk factors and a diagnostic nomogram for early prediction of gram-positive coccal etiology in spontaneous spinal infection.Infection · 2026Article
- Ceftazidime-Avibactam/Aztreonam Combination for the Treatment of Carbapenem-resistant Klebsiella pneumoniae-induced Osteomyelitis: A Case Series with Review of Literature.Journal of orthopaedic case reports · 2026Article
- Clinical Factors Associated with 90-Day Mortality in Patients Receiving Colistin Therapy for Multidrug-Resistant Gram-Negative Periprosthetic Joint Infection.Journal of clinical medicine · 2026Article
- Risk factors for treatment failure of surgical site deep infections following spinal instrumentation: multicentre observational study (DeFEndO study).Journal of bone and joint infection · 2026Article
- Use of Aztreonam-Avibactam with Rapid Eravacycline Step-Down Therapy for a Tibial Septic Non-Union by NDM-ProducingAntibiotics (Basel, Switzerland) · 2025Article
- An Overview of the Epidemiology of Multidrug Resistance and Bacterial Resistance Mechanisms: What Solutions Are Available? A Comprehensive Review.Microorganisms · 2025Review
- Emerging Concepts for the Treatment of Biofilm-Associated Bone and Joint Infections with IV Fosfomycin: A Literature Review.Microorganisms · 2025Review
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Multidrug (MDR) and extensive drug (XDR) resistance in Gram-negative bacteria (GNB) emerges worldwide. Although bone and joint infections are mostly caused by Gram-positive bacteria, mainly Staphylococci, MDR GNB substantially increase also as a complication of hospitalization and previous antibiotic administration. This narrative review analyzes the epidemiological trend, current experimental data, and clinical experience with available therapeutic options for the difficult to treat (DTR) GNB implicated in bone and joint infections with or without orthopedic implants. The radical debridement and removal of the implant is adequate therapy for most cases, along with prompt and prolonged combined antimicrobial treatment by older and novel antibiotics. Current research and clinical data suggest that fluoroquinolones well penetrate bone tissue and are associated with improved outcomes in DTR GNB; if not available, carbapenems can be used in cases of MDR GNB. For XDR GNB, colistin, fosfomycin, tigecycline, and novel β-lactam/β-lactamase inhibitors can be initiated as combination schemas in intravenous administration, along with local elution from impregnated spacers. However, current data are scarce and large multicenter studies are mandatory in the field.
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