The classe of antibiotics, membrane-targeting drugs of last resort i.e. polymyxin and lipopeptide used to treat infections caused by multi-drug-resistant pathogens.
Polymyxins treat infections caused by carbapenem-resistant species such as Escherichia coli , Acinetobacter baumannii and Pseudomonas aeruginosa by targeting the membrane consist of lipopolysaccharide of most Gram negative species . By contrast, the lipopeptide daptomycin requires membrane phosphatidylglycerol for activity and is only used to treat infections caused by drug-resistant Gram-positive bacteria such as methicillin resistant Staphylococcus aureus and vancomycin-resistant enterococci.
Although having distinct targets, both antibiotic classes cause membrane disruption. Therefore, new approaches are desperately needed to improve the efficacy of polymyxins and lipopeptide antibiotics. This requires fundamental studies to determine their mechanisms of action, as well as clinical studies of combination therapies and the development of next generation members of these classes of antibiotics.