Baughman Robert P
Department of Internal Medicine, University of Cincinnati Medical Center, Cincinnati, Ohio 45267, USA.
J Intensive Care Med. 2009 Jul-Aug;24(4):230-41. doi: 10.1177/0885066609335660. Epub 2009 Jul 17.
Inadequate initial antimicrobial treatment in serious infections leads to increased mortality. Achieving adequate treatment is increasingly difficult because of the increasing prevalence of multidrug-resistant (MDR) pathogens. The carbapenems are potent, broad-spectrum antibiotics that have been shown to be safe and efficacious therapies in the treatment of serious infections. This review is intended to compare the 4 major members of the carbapenem class, which include imipenem, meropenem, ertapenem, and doripenem, with other widely used antimicrobial agents in the intensive care unit (ICU). The carbapenems are potent, broad-spectrum antibiotics that have been shown to be safe and efficacious therapies in the treatment of serious infections. They provide better gram-negative coverage than other beta-lactams and are stable against extended-spectrum beta-lactamases and AmpC beta-lactamases, making them effective in the treatment of many MDR bacteria. The newly approved carbapenem, doripenem, may help preserve the utility of the carbapenem class.
严重感染时初始抗菌治疗不充分会导致死亡率上升。由于多重耐药（MDR）病原体的日益流行，实现充分治疗变得越来越困难。碳青霉烯类是强效、广谱抗生素，已被证明是治疗严重感染安全有效的疗法。本综述旨在比较碳青霉烯类的4种主要药物，包括亚胺培南、美罗培南、厄他培南和多利培南，与重症监护病房（ICU）中其他广泛使用的抗菌药物。碳青霉烯类是强效、广谱抗生素，已被证明是治疗严重感染安全有效的疗法。它们比其他β-内酰胺类药物对革兰氏阴性菌有更好的覆盖范围，并且对超广谱β-内酰胺酶和AmpCβ-内酰胺酶稳定，使其对许多MDR细菌有效。新批准的碳青霉烯类药物多利培南可能有助于保持碳青霉烯类的效用。
