Role of newer antimicrobial agents in the treatment of mixed aerobic and anaerobic infections

Abstract

Mixed infections with aerobic and anaerobic bacteria are being recognized with increasing frequency in clinical practice. Several concepts regarding such infections are clinically significant for the physician. These include the presence and significance of species in the Bacteroides fragilis group at clinical sites of infection, the facilitation of B. fragilis virulence by beta-lactamase producing aerobic bacteria and the role of enterococci in such infections. In response to the need for new forms of therapy for mixed aerobic and anaerobic infections, several new classes of antimicrobial agents have been introduced. Some of these allow for the potential option of monotherapy in certain clinical settings. In addition to clinical and microbiologic efficacy, safety and cost-effectiveness are factors that must be addressed with regard to these agents.