In a hollow fiber infection model, meropenem-vaborbactam showed potent bactericidal activity against KPC-producing K. pneumoniae. The addition of an aminoglycoside enhanced bacterial killing and prevented resistance emergence, particularly in isolates with MIC values close to the susceptibility breakpoint, supporting combination therapy in selected high-risk infections.

In a retrospective study of 55 patients with KPC-producing Enterobacterales infections, TDM-guided continuous infusion of meropenem-vaborbactam achieved aggressive PK/PD targets in 96% of cases. Although microbiological failure remained more frequent in patients receiving CRRT or with intra-abdominal infections, this strategy may optimize bacterial eradication and reduce the risk of resistance.

A case of post-neurosurgical CNS infection caused by KPC- and NDM-producing K. pneumoniae demonstrated measurable cerebrospinal fluid penetration of meropenem-vaborbactam when combined with aztreonam. The report highlights the potential role of therapeutic drug monitoring to optimize treatment in complex CNS infections.

A neonatal study examined the clinical use of WHO RESERVE antibiotics in 4 newborns patients, including newer agents administered for suspected or confirmed multidrug-resistant infections. Three out of four cases ended with the death of the young patients. In particular, meropenem-vaborbactam at 40 mg/kg was used in a preterm female newborn of 33 weeks with sepsis with acute respiratory distress, caused by KPC K. pneumoniae, with onset of resistance to meropenem-vaborbactam. The patients died of hepatic failure and multiorgan damage. The findings highlight the increasing therapeutic complexity of neonatal infections and the need for microbiological confirmation, optimized dosing and dedicated antimicrobial-stewardship programmes.

In a multicentre US study including 613 patients with MDR Gram-negative infections, ceftazidime-avibactam achieved an overall clinical success rate of 64.8%. Early initiation was associated with improved clinical outcomes and lower 30-day mortality in patients who had not previously received active antimicrobial therapy.

A novel KPC-160 variant carrying a two-amino-acid deletion in the Ω-loop conferred cefiderocol resistance while remaining detectable by routine carbapenemase assays. The findings underline the importance of continuous genomic surveillance to identify emerging resistance mechanisms.

Exposure to ceftazidime-avibactam promoted the emergence of multiple blaKPC variants and altered biofilm production in KPC-producing K. pneumoniae. These adaptive mechanisms may influence both resistance development and susceptibility to alternative antibiotics.

A clinical case describes successful treatment with imipenem-cilastatin-relebactam of an infection caused by a KPC-producing organism with limited susceptibility to alternative β-lactam/β-lactamase inhibitor combinations. The report underlines the importance of detailed phenotypic and molecular characterization when selecting therapy for emerging KPC variants.

An in vitro study compared cefepime-zidebactam, aztreonam-avibactam and other recently developed agents against carbapenem-resistant hypervirulent Klebsiella pneumoniae. The susceptibility rates of CR-hvKP to cefepime/zidebactam and aztreonam/avibactam all exceeded 90%, with rates of 98.1% and 99.1%, respectively. CR-hvKP exhibited susceptibility rates of 57.5% and 65.1% to imipenem/relebactam and meropenem/vaborbactam, respectively. Several novel combinations retained activity against isolates carrying complex resistance determinants, supporting their potential role against this emerging high-risk pathogen.

A case report of a 71-year-old patient describes severe refractory hypokalaemia associated with ceftazidime-avibactam therapy in an elderly patient. Although rare, electrolyte monitoring should be considered, particularly in patients with renal impairment or prolonged treatme

Real-world therapeutic drug monitoring in critically ill obese patients showed that renal function strongly influenced cefiderocol exposure. Clinical outcomes appeared to depend more on patient condition than PK/PD target attainment alone, highlighting the importance of individualized dosing.

Whole-genome sequencing of ceftazidime-avibactam-resistant KPC-producing K. pneumoniae bloodstream isolates identified multiple KPC variants together with OmpK35/OmpK36 alterations as key resistance mechanisms, emphasizing the complexity of resistance evolution

Multidrug-resistant Gram-negative infections, especially CRE and difficult-to-treat Pseudomonas aeruginosa, are a major global health threat associated with rising incidence, high mortality, and major economic burden. Recarbrio – a combination of imipenem, cilastatin, and relebactam – was developed to address these infections by combining antibacterial activity, protection from renal degradation, and inhibition of class A and class C beta-lactamases, thereby restoring imipenem efficacy. Supported by clinical trial data such as RESTORE-IMI 1, it represents an evidence-based treatment option for severe MDR Gram-negative infections in critically ill patients.

This case report describes the successful use of oral delafloxacin monotherapy for MRSA prosthetic valve endocarditis, suggesting a potential role for oral step-down therapy in carefully selected patients. Further clinical evidence is needed to define its place in endocarditis management.

In 370 clinical Bacteroides isolates, delafloxacin showed potent in vitro anaerobic activity, with MIC50 values comparable or superior to most commonly used agents. Its broad antibacterial spectrum may support its use in mixed infections involving multidrug-resistant anaerobes

This review evaluates the microbiological, pharmacological and clinical characteristics of delafloxacin, an intravenous and oral fluoroquinolone approved for acute bacterial skin and skin-structure infections and community-acquired bacterial pneumonia. Its activity in acidic environments and broad spectrum may offer advantages in selected infections, although its use should remain guided by antimicrobial stewardship principles.

Delafloxacin concentrations were evaluated in the cerebrospinal fluid of a murin model receiving the antibiotic, providing new information on its penetration into the central nervous system. Notably, CSF penetration was 49%, and the Cmax/MIC ratios met PK/PD target for Staphylococcus and Streptococcus but not Enterobacterales. Although clinical evidence remains limited, the findings may support further investigation of delafloxacin for susceptible CNS infections in which therapeutic options are restricted.

An in vitro study evaluated delafloxacin against S. aureus and S. epidermidis strains in biofilm and intracellular bone-infection models. Delafloxacin demonstrated significant activity against levofloxacin-susceptible staphylococci within biofilms and osteoblasts, supporting further investigation in bone and joint infections.

A review of 18 studies suggests that multidose oritavancin is a promising off-label option for Gram-positive bone and joint infections, including osteomyelitis and prosthetic joint infections. Clinical success rates generally exceeded 70%, with a favorable safety profile and the potential to reduce hospitalization.

A patient with vancomycin-resistant E. faecium prosthetic valve endocarditis achieved sustained clinical and microbiological cure after sequential treatment with daptomycin/fosfomycin followed by weekly oritavancin. The case supports the potential role of long-acting oritavancin as outpatient sequential therapy in selected patients.

PK/PD simulations suggest that multidose oritavancin regimens consistently achieve pharmacodynamic targets against susceptible Gram-positive pathogens. These findings support the evaluation of optimized multidose schedules in prospective clinical studies.

Despite their clinical advantages, long-acting glycopeptides remain underused because of reimbursement, organizational, and regulatory barriers. The authors of this review emphasize the need for improved funding models and multidisciplinary pathways to expand equitable access to these agents.

This international Delphi consensus provides practical recommendations for the management of E. faecium bloodstream infections. While linezolid and high-dose daptomycin remain the preferred options for vanA-VRE, the document highlights oritavancin as a promising candidate for future randomized studies based on its potent in vitro activity.

This observational study conducted in Italy and Spain and including 27 patietns assessed oritavancin as sequential therapy for complicated Gram-positive bloodstream infections, including bloodstream infections (BSI) and infective endocarditis (IE). Clinical success was 100% in BSI cases and 85.7% in patients with IE. Potential savings were of €4235 per patient. These findings expand real-world evidence supporting oritavancin use to complete prolonged treatment outside hospital in carefully selected, clinically stable patients.

A case report describes the use of oritavancin as rescue therapy in a critically ill 65-years old patient with a severe methicillin-resistant Staphylococcus aureus infection. The favourable outcome supports the potential value of long-acting lipoglycopeptides when conventional therapeutic strategies are ineffective, poorly tolerated or difficult to continue.

ABSSSI management across Italian expert centres is markedly variable, with limited round‑the‑clock specialist availability, uneven access to microbiology and wound care, absent structured pathways, weak GP–hospital links, and inconsistent monitoring and pharmacoeconomic assessment. A nine‑centre survey (107 items) identified these gaps and unmet needs, suggesting that strengthening multidisciplinary pathways, standardizing processes, and improving data systems could enhance care efficiency and consistency.

Over three years, a patient with recurrent MRSE bloodstream infections developed stepwise resistance to dalbavancin despite adequate drug exposure, accumulating mutations in walK, rpoB, and vraG. Dalbavancin combined with fosfomycin showed synergy in most isolates, while β-lactams were ineffective. The findings stress the need for combination therapy, optimized dosing, and source control to prevent resistance during long-term dalbavancin treatment.

A 2018–2022 analysis of clinical Enterococcus isolates identified vanA as the predominant resistance determinant, detected even in phenotypically susceptible strains. Transferable linezolid resistance via optrA was reported for the first time in Türkiye, while automated susceptibility testing showed limitations for linezolid detection. The study underscores the need for combined phenotypic and molecular surveillance to capture resistance mechanisms that routine methods may miss.