Levin Anna S, Oliveira Maura S
Shock. 2008 Oct;30 Suppl 1:30-3. doi: 10.1097/SHK.0b013e3181819cb8.
Infections caused by multidrug-resistant gram-negative bacteria are an increasing problem worldwide. Treatment of these microorganisms is a challenge because resistance limits dramatically therapeutic options. In this review, we discuss data of in vitro susceptibility and clinical studies of possible agents for the management of these infections. Currently, published data are limited, and there are no randomized clinical trials involving the treatment of infections caused by multidrug-resistant gram-negative rods. For imipenem-resistant Acinetobacter spp., most studied options are polymyxins and sulbactam. No newer antimicrobials active against Pseudomonas aeruginosa are available or under investigation. Tigecycline presents a broad spectrum of activity in vitro but has been studied mainly as treatment of community-acquired infections, as has ertapenem. They are potential options against extended-spectrum beta-lactamase-producing Enterobacteriaceae, and tigecycline may be useful in treating Acinetobacter infections.
耐多药革兰氏阴性菌引起的感染在全球范围内日益严重。这些微生物的治疗是一项挑战，因为耐药性极大地限制了治疗选择。在本综述中，我们讨论了用于治疗这些感染的可能药物的体外敏感性数据和临床研究。目前，已发表的数据有限，且尚无涉及耐多药革兰氏阴性杆菌所致感染治疗的随机临床试验。对于耐亚胺培南不动杆菌属，研究最多的选择是多粘菌素和舒巴坦。目前没有针对铜绿假单胞菌的新型抗菌药物可供使用或正在研究。替加环素在体外具有广泛的活性谱，但主要作为社区获得性感染的治疗药物进行研究，厄他培南也是如此。它们是治疗产超广谱β-内酰胺酶肠杆菌科细菌感染的潜在选择，替加环素可能对治疗不动杆菌感染有用。
