Drug-Drug Interactions in Recently Approved Antibacterials: A Mini Review.

Drug-drug interactions (DDIs) pose an important concern in elderly and multimorbid patients receiving complex pharmacotherapy. The addition of antimicrobial therapy can increase DDI risk, potentially reducing therapeutic efficacy or increasing toxicity. This review evaluates pharmacokinetic DDIs associated with antibacterial agents approved between 2012 and 2024 in the European Union (EU) and UK. To this end, all studies published on recently introduced antibiotics were consulted, with a focus on cytochrome P450 (CYP450) modulation, renal transporter interactions, and their clinical implications, excluding the papers concerning pharmacodynamics and spectrum of action. A systematic search of the PubMed database and summary of product characteristics (SmPCs) was conducted using key terms such as "drug-drug interaction," "DDI," "antibiotic," and "CYP450," combined with the name of the respective antibacterial agent. Human data were prioritized, although in vitro studies were included when clinical data were unavailable. Among the evaluated agents, cefiderocol, oritavancin, and meropenem/vaborbactam showed capacity for CYP450-mediated interactions. Although most examined antibiotics carry minimal risk of CYP-mediated DDIs, interactions with renal transporters may still pose clinical concerns, particularly when coadministered with nephrotoxic drugs. In conclusion, most recently approved antibiotics have a low potential for interaction, but certain agents may carry clinically significant risks, especially in vulnerable patient populations. Oritavancin poses notable clinical concern owing to its higher degree of CYP450‑mediated interactions. Further clinical studies are warranted to validate in vitro findings to better characterize the relevance of DDIs involving these novel agents.