• Silvia Dettori, Federica Portunato, Antonio Vena, Daniele Roberto Giacobbe, and Matteo Bassetti.
• Infectious Diseases Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neuroscience.
• Curr Opin Crit Care. 2023 Oct 1; 29 (5): 438445438-445.

Purpose Of ReviewAntimicrobial resistance (AMR) in Gram-negative bacteria (GNB) poses a significant global health concern, contributing to increased infections, mortality rates, and healthcare costs. This review discusses the main clinical manifestations, therapeutic options, and recent findings in managing antibiotic-resistant GNB, with a focus on difficult-to-treat infections.Recent FindingsDifficult-to-treat resistance (DTR) is a novel classification that identifies GNB exhibiting intermediate or resistant phenotypes to first-line agents in the carbapenem, beta-lactam, and fluoroquinolone categories. The main pathogens implicated in severe infections include DTR Enterobacterales, DTR Pseudomonas aeruginosa , and DTR Acinetobacter baumannii. Although the clinical implications of DTR strains are still under investigation, certain studies have linked them to prolonged hospital stays and poor patient outcomes.SummarySevere infections caused by DTR-GNB pose a formidable challenge for healthcare providers and represent a growing global health issue. The proper administration and optimization of novel antibiotics at our disposal are of paramount importance for combating bacterial resistance and improving patient prognosis.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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