2nd Division of Infectious Diseases, National Institute for Infectious Diseases Lazzaro Spallanzani, Rome, Italy.
Expert Rev Anti Infect Ther. 2013 Feb;11(2):159-77. doi: 10.1586/eri.12.162.
The increasing incidence of carbapenem-resistant Klebsiella pneumoniae (CR-KP) fundamentally alters the management of patients at risk to be colonized or infected by such microorganisms. Owing to the limitation in efficacy and potential for toxicity of the alternative agents, many experts recommend using combination therapy instead of monotherapy in CR-KP-infected patients. However, in the absence of well-designed comparative studies, the best combination for each infection type, the continued role for carbapenems in combination therapy and when combination therapy should be started remain open questions. Herein, the authors revise current microbiological and clinical evidences supporting combination therapy for CR-KP infections to address some of these issues.
碳青霉烯类耐药肺炎克雷伯菌（CR-KP）的发病率不断增加，从根本上改变了对有此类微生物定植或感染风险的患者的治疗管理。由于替代药物的疗效有限且存在潜在毒性，许多专家建议对 CR-KP 感染患者使用联合治疗而非单药治疗。然而，由于缺乏精心设计的对照研究，对于每种感染类型的最佳联合方案、碳青霉烯类药物在联合治疗中的持续作用以及何时开始联合治疗等问题仍存在争议。在此，作者回顾了目前支持 CR-KP 感染联合治疗的微生物学和临床证据，以解决其中的一些问题。
