Hong Mai-Chi, Hsu Donald I, Bounthavong Mark
Department of Pharmacy Practice and Administration, Western University of Health Sciences, Pomona, CA, USA.
Department of Pharmacy Practice and Administration, Western University of Health Sciences, Pomona, CA, USA ; Department of Pharmacy, St Joseph Hospital, Orange, CA, USA.
Infect Drug Resist. 2013 Nov 29;6:215-23. doi: 10.2147/IDR.S36140.
The management of infections caused by multidrug-resistant Gram-negative bacteria, particularly Pseudomonas aeruginosa, continues to be a significant challenge to clinicians. Ceftolozane/tazobactam is a novel antibacterial and β-lactamase-inhibitor combination that has shown appreciable activity against wild-type Enterobacteriaceae and potent activity against P. aeruginosa. Moreover, ceftolozane/tazobactam has not demonstrated cross-resistance to other antimicrobial classes, particularly those affected by extended-spectrum β-lactamases, AmpC β-lactamase, a loss in porin channels, or the overexpression of efflux pumps in P. aeruginosa. Ceftolozane/tazobactam has completed two Phase II clinical trials in complicated intra-abdominal and complicated urinary tract infections. A Phase III, multicenter, prospective, randomized, open-label study has been initiated to evaluate the safety and efficacy of ceftolozane/tazobactam versus piperacillin/tazobactam for the treatment of ventilator-associated pneumonia. A Medline search of articles from inception to May 2013 and references for selected citations was conducted. Data from abstracts presented at conferences were also appraised. This article reviews the antimicrobial, pharmacokinetic, and pharmacodynamic profile of ceftolozane/tazobactam, and discusses its potential role in therapy.
耐多药革兰氏阴性菌感染的管理,尤其是铜绿假单胞菌感染,仍然是临床医生面临的重大挑战。头孢洛扎/他唑巴坦是一种新型抗菌药物与β-内酰胺酶抑制剂的组合,已显示出对野生型肠杆菌科细菌有可观的活性,对铜绿假单胞菌有强效活性。此外,头孢洛扎/他唑巴坦对其他抗菌药物类别未表现出交叉耐药性,特别是那些受超广谱β-内酰胺酶、AmpCβ-内酰胺酶、孔蛋白通道丧失或铜绿假单胞菌中流出泵过度表达影响的抗菌药物。头孢洛扎/他唑巴坦已完成两项针对复杂性腹腔内感染和复杂性尿路感染的II期临床试验。一项III期、多中心、前瞻性、随机、开放标签研究已启动,以评估头孢洛扎/他唑巴坦与哌拉西林/他唑巴坦治疗呼吸机相关性肺炎的安全性和有效性。对截至2013年5月发表的文章进行了Medline检索,并查阅了选定引文的参考文献。还评估了会议上发表的摘要数据。本文综述了头孢洛扎/他唑巴坦的抗菌、药代动力学和药效学特征,并讨论了其在治疗中的潜在作用。