Impact of Next-Generation Antibiotics on DTR Gram-Negative Infections in the U.S.

Background: Difficult-to-treat resistant (DTR) gram-negative infections are defined by resistance to all first-line, safe, and effective antibiotics, including all β-lactams and fluoroquinolones. These infections are associated with a 40% higher mortality rate than susceptible infections. Although 9 newer antibiotics with improved safety and efficacy have been approved by the Food and Drug Administration (FDA) since 2014, their real-world impact on patient survival remains unclear. Objective: To evaluate whether and why mortality in patients with DTR infections has changed since the introduction of 9 newer FDA-approved antibiotics in the United States. Design: Retrospective cohort study. Methods: The study used data from the PINC-AI Healthcare Database, identifying adult patients across U.S. hospitals between January 2016 and August 2023. The study included 5065 encounters with DTR Enterobacterales, Pseudomonas aeruginosa , or Acinetobacter baumannii . Researchers used a generalized more...