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Abstract: For more than 20 years, hospital and community-acquired antimicrobial resistances regularly increase. In France, methicilline-resistant Staphylococcus aureus (MRSA) and extended-spectrum β-lactamase-producing Enterobacteriaceae are the most common resistant pathogens. Previous hospitalisation, surgery, long length of stay, enteral feeding and antibiotic exposure are the main risk factors associated with nosocomial MRSA infections. To limit the emergence of resistances, control strategies have been implemented, based on isolation practices, healthcare workers education, strict hand hygiene and a controlled use of antibiotics. However, new antimicrobials acting by a novel mechanism of action are necessary in fighting the most resistant organisms. Therefore, the launch on the American market in June 2005 of tigecycline, a first-in-class glycylcycline indicated in the treatment of complicated skin and skin structure infections and complicated intra-abdominal infections, will provide to physicians a new therapeutic option against hospital or community-acquired resistant pathogens. The data presented to ICAAC indicate its expended broad spectrum of in vitro activity against Gram positives, Gram negatives, anaerobes and against number of difficult-to-treat resistant isolates, such as hospital or community-acquired MRSA, vancomycine resistant Enterococcus but also ESBL-producing organisms. [Copyright &y& Elsevier]

Abstract: Antimicrobial resistance is an increasing public health concern, all the more as it is concurrently accompanied by limited antimicrobial drugs development, especially broad-spectrum antibiotics. Tigecycline, the first in the novel glycylcycline class to undergo clinical development, showed extensive in vitro activity against a broad range of Gram positive aerobes, among which Staphylococcus aureus, Streptococcus pneumoniae, and Gram negative pathogens, such as Haemophilus influenzae and enterobacteriae, despite these germs resistance to β-lactams, vancomycin, and a number of other common antibiotics. Tigecycline is also active against some anaerobes. Data obtained in phase II clinical trials have shown good tolerance and efficacy of tigecycline administered by intravenous infusion in the treatment of complicated skin and skin structure infections and intra-abdominal infections. Should these results be confirmed by phase III clinical trials, tigecycline would provide a new option in the ongoing fight against resistant pathogens, which would usefully add to the present antibacterial armamentarium, particularly in severe or hospital treated infections. [Copyright &y& Elsevier]

The adequate use of antibiotic drugs depends not only on prescribers but also on patient compliance. We had an aim of assessing the perception of antibiotic treatment by patients (or their parents, for children) in some European countries.Method. – Three thousand representative (quota method) European patients (France, Germany, Italy, Spain) were included in the study. They had all been given antibiotherapy for NARI and answered a questionnaire presented by an enquirer, in a one on one interview.Results. – Four types of patients were identified according to their relationship with the physician: implicated (30%), deferent (23%), indifferent (13%), critical (17%). “Implicated” patients were mostly French and German, “deferent” patients were mostly French and Spanish, “indifferent” patients were mostly Italian. “Implicated” and “deferent” patients were the most satisfied of information given by the physician, 43% and 39% compared to 17% and 16% for “indifferent” and “critical” (P < 0.01). They were more aware of the adequate use of antibiotic drugs 80% and 80% vs. 38% and 62% (P < 0.01). They better understood the frequency of administration and the duration of treatment (77% and 77% vs. 36% and 60%). They were more observant (91% vs. 86%, P < 0.001).Comments. – The physician/patient relationship is correlated to the subjective perception of treatment, but also to prescription observance. The quality of this relationship is essential for an adequate use of antibiotic drugs. [Copyright &y& Elsevier]