Division of Infectious Diseases, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, 111 East 210th Street, Bronx, NY 10467, USA.
Division of Infectious Diseases, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, 111 East 210th Street, Bronx, NY 10467, USA.
Int J Infect Dis. 2017 Oct;63:7-12. doi: 10.1016/j.ijid.2017.07.019. Epub 2017 Aug 5.
Staphylococcal bacteremia and enterococcal bacteremia are prevalent in hospitalized or recently instrumented patients, and are associated with significant morbidity and mortality. They are often difficult to treat due to the pathogenicity of the organisms, poor response to antibiotics, and increasing development of multidrug resistance. Therefore, there has been increasing interest in combination therapy for the treatment of these infections. The aim of this review was to summarize and assess the evidence supporting combination beta-lactam therapy for both Staphylococcus aureus and Enterococcus species blood stream infections. Currently, there is promising in vitro data but little clinical evidence supporting combination beta-lactam therapy for this indication. Further clinical investigations are needed to elucidate the potential benefits of beta-lactam combination therapy over monotherapy for Gram-positive bacteremia, although combination therapy may be useful in refractory cases of bacteremia that do not respond to standard antibiotic therapy.
金黄色葡萄球菌菌血症和肠球菌菌血症在住院或近期接受器械治疗的患者中较为常见，与较高的发病率和死亡率相关。由于病原体的致病性、对抗生素的反应不佳以及多药耐药性的不断发展，这些感染通常难以治疗。因此，人们越来越关注联合治疗这些感染的方法。本综述的目的是总结和评估支持治疗金黄色葡萄球菌和肠球菌血流感染的联合β-内酰胺治疗的证据。目前，有有前景的体外数据，但支持该适应证联合β-内酰胺治疗的临床证据有限。需要进一步的临床研究来阐明β-内酰胺联合治疗相对于革兰阳性菌血症的单药治疗的潜在益处，尽管联合治疗可能对不响应标准抗生素治疗的难治性菌血症病例有用。
