Multidrug-resistant gram-negative bacilli is a pressing contemporary concern, compounded by the paucity of new antibiotics say infectious disease experts.

In a clinical focus article in the MJA the experts from the University of Queensland and Monash Health in Victoria explain the current gram-negative resistance landscape in Australia and its implications for clinical care.

Recent reports by the World Health Organization show “alarmingly high” rates of bacterial resistance across all WHO regions.

This is not just a problem in hospitalised patients; community-acquired infections are now increasingly likely to be caused by resistant bacteria, said the authors led by Dr Patrick Harris.

The emerging phenomenon of multidrug-resistant (MDR) gram-negative bacilli (GNB) is a pressing contemporary concern, they wrote.

The challenge has been compounded by the paucity of new antibiotics in late-stage development, without which effective antibiotics, many health care interventions (such as intensive care, transplantation or orthopaedic surgery) would be excessively risky.

“With limited prospects for new antibiotics in late-stage development that are active against Multidrug-resistant gram-negative bacilli, our national response to these challenges will require a multifaceted approach, including widespread implementation of antimicrobial stewardship, enhanced surveillance, targeted screening of at-risk patients and improved infection control practices,” they wrote.

In the longer term, restriction of agricultural use of antibiotic classes critical to human medicine, removal of barriers to new drug development, and technological advances in rapid microbiological diagnostics will be required, they added.