Departments of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Departments of Pharmacy, Johns Hopkins University School of Medicine, Baltimore, Maryland.
J Pediatric Infect Dis Soc. 2019 Jul 1;8(3):251-260. doi: 10.1093/jpids/piz002.
With the current carbapenem-resistant organism crisis, conventional approaches to optimizing pharmacokinetic-pharmacodynamic parameters are frequently inadequate, and traditional salvage agents (eg, colistin, tigecycline, etc) confer high toxicity and/or have low efficacy. However, several β-lactam agents with activity against carbapenem-resistant organisms were approved recently by the US Food and Drug Administration, and more are anticipated to be approved in the near future. The primary goal of this review is to assist infectious disease practitioners with preferentially selecting 1 agent over another when treating patients infected with a carbapenem-resistant organism. However, resistance to some of these antibiotics has already developed. Antibiotic stewardship programs can ensure that they are reserved for situations in which other options are lacking and are paramount for the survival of these agents.
随着当前碳青霉烯类耐药菌危机的出现，优化药代动力学-药效学参数的常规方法往往不够充分，传统的挽救性药物（如多粘菌素、替加环素等）具有高毒性和/或低疗效。然而，最近美国食品和药物管理局批准了几种对碳青霉烯类耐药菌有活性的β-内酰胺类药物，预计在不久的将来还会有更多的药物获得批准。本综述的主要目的是帮助传染病医生在治疗感染碳青霉烯类耐药菌的患者时，优先选择一种药物而不是另一种药物。然而，这些抗生素中的一些已经产生了耐药性。抗生素管理计划可以确保这些药物仅在缺乏其他选择的情况下使用，并且对于这些药物的生存至关重要。
