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Facing the challenge of multidrug-resistant gram-negative bacilli in Australia

Antimicrobial resistance is a major challenge for current and future medical practice.1,2 Yet the magnitude of the problem we face and its solutions are not obvious. It is estimated that at least 2 million people acquire infections with bacteria that are resistant to standard therapy each year in the United States alone.3 The World Health Organization recently reported alarmingly high rates of bacterial resistance across all WHO regions.2 This is not just a problem in hospitalised patients; community-acquired infections are now increasingly likely to be caused by resistant bacteria.4

The emerging phenomenon of multidrug-resistant (MDR) gram-negative bacilli (GNB) is a pressing contemporary concern. This challenge has been compounded by the paucity of new antibiotics in late-stage development for MDR GNB. Without effective antibiotics, many health care interventions (such as intensive care, transplantation or orthopaedic surgery) would be excessively risky. In this article, we aim to describe the current gram-negative resistance landscape in Australia and the implications for clinical care more broadly.

Antimicrobial resistance in gram-negative bacilli

Standardised definitions for multidrug resistance in GNB have recently been promulgated…