76:
267:
Agents classified as fourth-line (or greater) treatments or experimental therapies could be considered by default to be drugs of last resort due to their low placement in the treatment hierarchy. Such placement may result from a multitude of considerations, including greater efficacy of other agents,
230:
Due to the possibility of potential severe or fatal consequences of resistant strains, initial treatment often includes concomitant administration of multiple antimicrobial agents that are not known to show cross-resistance, so as to reduce the possibility of a resistant strain remaining inadequately
196:
With regard to antibiotics, antivirals, and other agents indicated for treatment of infectious pathological disease, drugs of last resort are commonly withheld from administration until after the trial and failure of more commonly used treatment options to prevent the development of drug resistance.
165:
The use of a drug of last resort may be based on agreement among members of a patient's care network, including physicians and healthcare professionals across multiple specialties, or on a patient's desire to pursue a particular course of treatment and a practitioner's willingness to administer that
1267:
Krings-Ernst, Ilana; Ulrich, Sven; Adli, Mazda (1 October 2013). "Antidepressant
Treatment with MAO-Inhibitors During General and Regional Anesthesia: a Review and Case Report of Spinal Anesthesia for Lower Extremity Surgery Without Discontinuation of Tranylcypromine".
272:
or similar issues relating to patient tolerance. Some experimental therapies might also be called drugs of last resort when administered following the failure of all other currently accepted treatments.
433:) are indicated in heavily treatment-experienced adults with multidrug-resistant HIV-1 infection failing their current antiretroviral regimen due to resistance, intolerance, or safety considerations.
231:
treated by a single agent during the evaluation of drug response. Once a specific resistance profile has been isolated via clinical laboratory findings, treatment is often modified as indicated.
193:
agents. These agents often exhibit what are considered to be among the most efficient dose-response related effects, or are drugs for which few or no resistant strains are known.
181:
related efficacy in time-critical situations such as high mortality circumstances. Many of the drugs considered last resorts fall into one or more of the categories of
197:
One of the most commonly known examples of both antimicrobial resistance and the relationship to the classification of a drug of last resort is the emergence of
1303:
260:) that have shown efficacy in highly drug-resistant strains. There are also strains of enterococci that have developed resistance to vancomycin referred to as
1001:
Schulte, P. (2003). "What is an adequate trial with clozapine?: therapeutic drug monitoring and time to response in treatment-refractory schizophrenia".
58:
pathogens and tumors. Such an alternative may be outside of extant regulatory requirements or medical best practices, in which case it may be viewed as
276:
Although most of the notable drugs of last resort are antibiotics or antivirals, other drugs are sometimes considered drugs of last resort, such as
237:
has long been considered a drug of last resort, due to its efficiency in treating multiple drug-resistant infectious agents and the requirement for
1066:
Costa, Caroline S; Bagatin, Ediléia; Martimbianco, Ana Luiza C; da Silva, Edina MK; Lúcio, Marília M; Magin, Parker; Riera, Rachel (2018-11-24).
658:
540:— used in treatment-resistant schizophrenia not responsive to at least two different antipsychotics; the main reason for such restriction is
227:, with an emphasis on evaluating the response to initial treatment and laboratory diagnostic techniques to isolate cases of drug resistance.
177:
Therapies considered to be drugs of last resort may at times be used earlier in the event that an agent would likely show the most immediate
941:"Infectious Disease & Antimicrobial Agents - Trypanosoma brucei gambiense and Trypanosoma brucei rhodesiense (African Trypanosomiasis)"
498:(IBS-D) in females not responsive to conventional therapy. Its use is restricted due to serious gastrointestinal adverse reactions, e.g.
198:
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246:
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919:"Sunlenca (lenacapavir) Tablets, for Oral Use; Sunlenca (lenacapavir) Injection, for Subcutaneous Use. Full Prescribing Information"
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Grady, MM; Stahl, SM (26 April 2012). "Practical Guide for
Prescribing MAOIs: Debunking Myths and Removing Barriers".
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Hypertension and you : old drugs, new drugs, and the right drugs for your high blood pressure
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and can permanently dry out the skin all over the body and is therefore not the first treatment.
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898:"Rukobia (fostemsavir) Extended-Release Tablets, for Oral Use. Full Prescribing Information"
701:
who are not appropriate candidates for other adjunctive therapies. Use is restricted due to
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course. Certain situations such as severe bacterial related
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have shown to exhibit). In cases presenting with suspected
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Grace, Eddie; Asbill, Scott; Virga, Kris (November 2015).
1309:. Validus Pharmaceuticals. pp. 2, 5. Archived from
778:"FDA tells doctors to use heartburn drug as last resort"
1266:
1047:. MedlinePlus : U.S. National Library of Medicine
580:— when all topical treatments or antibiotics against
395:
exist. Unacceptably high risk of irreversible, fatal
365:
in patients with limited or no alternative options.
268:socioeconomic considerations, availability issues,
1159:
751:The American Heritage Stedman's Medical Dictionary
748:
566:. Its use is associated with an increased risk of
1242:(3rd ed.). New York: Facts On File. p.
1238:The Encyclopedia of the Brain and Brain Disorders
1349:
1233:
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457:, resulting in death in around 5% of patients.
635:minoxidil is a first-line drug for hair loss.
252:(VRSA) or vancomycin intermediate-resistance
596:when taken while pregnant, is said to cause
357:— a cephalosporin used to treat complicated
347:); use is limited to prevent development of
102:introducing citations to additional sources
1072:The Cochrane Database of Systematic Reviews
711:— used only in extreme treatment-resistant
675:) after prenatal use by pregnant women, US
1190:
415:; carries risk of kidney and nerve damage.
221:Centers for Disease Control and Prevention
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683:(ENL) in 1998, and 2008 for new cases of
526:/hypnotic agent used in the treatment of
641:— due to potentially lethal dietary and
544:and other severe side effects including
174:can more commonly lead to last resorts.
92:Relevant discussion may be found on the
1000:
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361:(cUTI) caused by multi-drug resistant
315:are often severe or potentially fatal.
938:
823:Antimicrobial Agents and Chemotherapy
339:active against methicillin-resistant
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951:from the original on 7 February 2024
69:
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309:primary amoebic meningoencephalitis
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1234:Turkington, C; Harris, JR (2009).
755:. Houghton Mifflin Company. 2004.
502:and complications of constipation.
371:— formerly first-line therapy for
14:
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926:U.S. Food and Drug Administration
905:U.S. Food and Drug Administration
288:
262:vancomycin resistant enterococcus
1015:10.2165/00003088-200342070-00001
869:. US Centers for Disease Control
85:relies largely or entirely on a
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776:Ciment, J. (5 February 2000).
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715:due to the risk of permanent
1068:"Oral isotretinoin for acne"
677:Food and Drug Administration
639:Monoamine oxidase inhibitors
373:Rocky Mountain spotted fever
303:— used for life-threatening
7:
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283:
65:
10:
1379:
245:(sometimes referred to as
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1205:10.1017/S109285291200003X
1003:Clinical Pharmacokinetics
681:erythema nodosum leprosum
679:approved thalidomide for
217:World Health Organization
52:antineoplastic resistance
1158:Mann, Samuel J. (2012).
794:10.1136/bmj.320.7231.336
697:— used in patients with
512:(GERD); carries risk of
496:irritable bowel syndrome
423:HIV attachment inhibitor
381:bacterial conjunctivitis
359:urinary tract infections
48:antimicrobial resistance
19:Not to be confused with
1131:(1): 2. March 1, 1980.
455:reactive encephalopathy
447:African trypanosomiasis
383:, and systemically for
270:unpleasant side effects
363:Gram-negative bacteria
1358:Clinical pharmacology
612:acutely decompensated
341:Staphylococcus aureus
247:vancomycin resistant
200:Staphylococcus aureus
113:"Drug of last resort"
835:10.1128/AAC.01293-15
431:HIV capsid inhibitor
98:improve this article
699:Parkinson's disease
687:(administered with
647:hypertensive crisis
562:used in refractory
335:— fifth-generation
323:imipenem/cilastatin
56:multidrug-resistant
40:pharmaceutical drug
34:), also known as a
28:drug of last resort
1363:Medical treatments
1137:10.1007/BF03292651
651:serotonin syndrome
645:which may trigger
534:are not effective.
528:alcohol withdrawal
508:— used for severe
401:gray baby syndrome
387:when allergies to
1316:on 18 August 2017
1177:978-1-4422-1517-7
939:Pepin, J (2014).
829:(11): 6677–6681.
643:drug interactions
514:heart arrhythmias
442:T. b. rhodesiense
305:fungal infections
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369:Chloramphenicol
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295:Aminoglycosides
291:
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60:salvage therapy
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289:Antimicrobials
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83:This article
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907:. June 2020.
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871:. Retrieved
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629:hypertension
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608:Levosimendan
578:Isotretinoin
476:
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329:Ceftobiprole
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191:chemotherapy
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172:septic shock
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16:Type of drug
1341:. Lundbeck.
1199:(1): 2–10.
1045:"Felbamate"
717:vision loss
673:tetraamelia
665:Thalidomide
550:myocarditis
486:Other drugs
467:Tigecycline
437:Melarsoprol
427:lenacapavir
419:Fostemsavir
412:Pseudomonas
377:doxycycline
355:Cefiderocol
333:ceftaroline
319:Carbapenems
239:intravenous
183:antibiotics
36:heroic dose
1352:Categories
987:2019-12-21
736:References
709:Vigabatrin
669:phocomelia
631:, however
610:— used in
598:depression
590:nosebleeds
478:Legionella
389:penicillin
385:meningitis
235:Vancomycin
187:antivirals
154:March 2020
124:newspapers
46:, such as
1221:206312008
1145:198213029
1092:1469-493X
695:Tolcapone
625:minoxidil
602:hair loss
592:, causes
556:Felbamate
538:Clozapine
506:Cisapride
492:Alosetron
461:Linezolid
321:(such as
278:cisapride
258:linezolid
254:S. aureus
249:S. aureus
243:S. aureus
225:S. aureus
213:S. aureus
209:S. aureus
205:S. aureus
94:talk page
1290:23993253
1213:22790112
1125:InPharma
1110:30484286
1031:25525638
1023:12844323
949:Archived
873:12 March
853:26259797
724:See also
713:epilepsy
564:epilepsy
546:seizures
524:sedative
445:type of
407:Colistin
284:Examples
66:Purposes
1101:6383843
955:27 July
844:4604384
803:1173548
649:and/or
633:topical
375:(until
264:(VRE).
138:scholar
38:, is a
1320:22 May
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