Takimoto Kohei, Wang Qianzhi, Suzuki Daisuke, Katayama Mitsuya, Hayashi Yoshiro
a Department of Intensive Care Medicine , Kameda Medical Center , Kamogawa , Japan.
b Postgraduate Education Center , Kameda Medical Center , Kamogawa , Japan.
Expert Opin Pharmacother. 2017 Jul;18(10):1027-1034. doi: 10.1080/14656566.2017.1341491. Epub 2017 Jun 23.
Complicated skin and soft tissue infections (cSSTIs) are skin and soft tissue infections (SSTIs) that involve deep soft tissue. cSSTIs often require surgical intervention and/or hospitalization. cSSTIs are associated with significant mortality and morbidity, and carry a significant burden on health care systems. Piperacillin/tazobactam has been regarded as a standard treatment for cSSTIs because of its antibiotic spectrum, safety and clinical efficacy. Several antibiotics, as compared to piperacillin/tazobactam, have been evaluated in the treatment of cSSTIs. Areas covered: This review summarizes randomized controlled trials (RCTs) evaluating the clinical efficacy of piperacillin/tazobactam for the treatment of cSSTIs. Expert opinion: Piperacillin/tazobactam, which covers most causative organisms in cSSTIs, is the drug of choice for the treatment of cSSTIs. Other options such as ertapenem and moxifloxacin may be reasonable where multiple daily dosing or intravenous administration is inappropriate. But in general, they should be avoided as an empirical treatment because of their highly association with resistant bacteria, which are becoming a global threat. Therefore, piperacilin/tazobactam is appropriate as an empirical therapy for the treatment of SSTIs and should be de-escalated as soon as causative organisms are identified, their drug-sensitivity results are available, and clinical condition becomes stable.
复杂皮肤及软组织感染（cSSTIs）是累及深部软组织的皮肤及软组织感染（SSTIs）。cSSTIs通常需要手术干预和/或住院治疗。cSSTIs与显著的死亡率和发病率相关，给医疗保健系统带来重大负担。哌拉西林/他唑巴坦因其抗菌谱、安全性和临床疗效，一直被视为cSSTIs的标准治疗药物。与哌拉西林/他唑巴坦相比，已有多种抗生素被评估用于治疗cSSTIs。涵盖领域：本综述总结了评估哌拉西林/他唑巴坦治疗cSSTIs临床疗效的随机对照试验（RCTs）。专家观点：哌拉西林/他唑巴坦覆盖了cSSTIs中的大多数致病微生物，是治疗cSSTIs的首选药物。在每日多次给药或静脉给药不合适的情况下，厄他培南和莫西沙星等其他选择可能是合理的。但一般来说，由于它们与耐药菌高度相关，而耐药菌正成为全球威胁，因此应避免将其作为经验性治疗药物。因此，哌拉西林/他唑巴坦适合作为SSTIs的经验性治疗药物，一旦确定致病微生物、获得其药敏结果且临床状况稳定，就应尽快降阶梯治疗。
