Renaissance of vancomycin: approaches for breaking antibiotic resistance in multidrug-resistant bacteria

Can J Microbiol. 2020 Jan;66(1):11-16. doi: 10.1139/cjm-2019-0309. Epub 2019 Sep 23.

Abstract

The emergence of multidrug-resistant bacteria demands innovations in the development of new antibiotics. For decades, the glycopeptide antibiotic vancomycin has been considered as the "last resort" treatment of severe infections caused by Gram-positive bacteria. Since the discovery of the first vancomycin-resistant enterococci strains in the late 1980s, the number of resistances has been steadily rising, with often life-threatening consequences. As an alternative to the generation of completely new substances, novel approaches focus on structural modifications of established antibiotics such as vancomycin to overcome these resistances. Here, we provide an overview of several promising modifications of vancomycin to restore its efficacy against vancomycin-resistant enterococci.

Keywords: antibiotics; antibiotiques; bactérie multirésistante aux médicaments; enterococci; entérocoques; modification structurale; multidrug-resistant bacteria; structural modification; vancomycin; vancomycine.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / chemistry
  • Anti-Bacterial Agents / pharmacology*
  • Drug Resistance, Multiple, Bacterial / drug effects*
  • Gram-Positive Bacteria / drug effects
  • Gram-Positive Bacteria / isolation & purification
  • Gram-Positive Bacterial Infections / microbiology
  • Humans
  • Structure-Activity Relationship
  • Vancomycin / chemistry*
  • Vancomycin / pharmacology*
  • Vancomycin Resistance*

Substances

  • Anti-Bacterial Agents
  • Vancomycin