Rahal James J
Infectious Disease Section and Lang Research Center, New York Hospital Queens, and Department of Medicine, Weill College of Medicine, Cornell University, New York, New York 11355-5095, USA.
Clin Infect Dis. 2006 Sep 1;43 Suppl 2:S95-9. doi: 10.1086/504486.
For infections with antibiotic-susceptible strains of Pseudomonas aeruginosa, most studies have suggested that combination therapy, usually with a beta -lactam antibiotic plus an aminoglycoside, is preferable for patients with bacteremia and neutropenia. Against infections with Pseudomonas aeruginosa or Acinetobacter baumannii isolates that are resistant to all antibiotics except the polymyxins, several novel antibiotic combinations demonstrate increased activity in vitro compared with that of any single agent. Whether these combinations yield outcomes that are improved over those seen with a polymyxin or other agent alone remains to be determined. However, against infections with species resistant to all antibiotics, including polymyxins, novel combinations are the only remaining therapeutic option.
对于由对抗生素敏感的铜绿假单胞菌菌株引起的感染，大多数研究表明，对于菌血症和中性粒细胞减少症患者，通常采用β-内酰胺类抗生素加氨基糖苷类抗生素的联合治疗更为可取。对于由对除多粘菌素外的所有抗生素均耐药的铜绿假单胞菌或鲍曼不动杆菌分离株引起的感染，与任何单一药物相比，几种新型抗生素联合用药在体外显示出增强的活性。这些联合用药是否能产生比单独使用多粘菌素或其他药物更好的疗效仍有待确定。然而，对于由对包括多粘菌素在内的所有抗生素均耐药的菌种引起的感染，新型联合用药是唯一剩下的治疗选择。
