Common problems and solutions in the management of resistant gram-negative bacterial infections: Expert opinion on clinical practice

Abstract

Antimicrobial resistance (AMR) in gram -negative bacteria is an escalating public health challenge nationally and globally. Since the beginning of the 2000s, antimicrobial resistance surveillance systems involving diverse stakeholders, including human healthcare, animal health, and agriculture, have been established worldwide under the leadership of the World Health Organization, merging local AMR data and enabling the periodic release of reports on the AMR landscape, both regionally and internationally. As a result, crucial components of an antimicrobial stewardship program have been identified, and implementation has been initiated at the national level. However, considering the dynamic nature of AMR, it becomes apparent that existing guidelines and consensus reports, which offer evidence -based, current literature insights and recommendations, may struggle to keep pace with the requirements of everyday clinical practice. As this group of experts decided to prepare a guidance document tailored for Turkish clinicians, aimed at aiding in the diagnosis and treatment of gram -negative bacterial infections with AMR in hospitalized patients, the Infectious Diseases Society of America (IDSA) published the "2023 Guidance for the Treatment of AMD-Resistant Gram -Negative Infections" in July 2023. This indicates that the developments in the field of AMR cannot be addressed by the guidelines in a timely manner. As Turkish Infectious Diseases and Clinical Microbiology specialists, we aspire for this article to serve as a valuable resource, offering guidance for healthcare practitioners across various medical disciplines who treat patients afflicted by resistant gram -negative infections.