Department of Medical Sciences, Infectious Diseases, University of Turin, Turin.
Department of Clinical Medicine and Surgery, Section of Infectious Disease, University of Naples Federico II, Naples, Italy.
Curr Opin Infect Dis. 2019 Dec;32(6):663-673. doi: 10.1097/QCO.0000000000000598.
describing the current role of carbapenems and carbapenem-sparing strategies in the setting of antimicrobial stewardship programs.
sparing carbapenems with other drugs appears to be an interesting perspective for a variety of reasons in the current context of the multidrug-resistant (MDR) pandemic. Specific algorithms should also be precisely investigated to define better how to spare carbapenems within empiric and targeted regimens, with combination treatment or monotherapies, aiming at the best use of the new drugs and improving de-escalation as soon as possible for most of the patients.
stewardship programs may be useful in reducing probable misuse and overuse of antibiotics, which has probably contributed to the emergence of carbapenem-resistant bacteria worldwide. The proposal of carbapenem-sparing strategies has then generated substantial scientific debate and, overall, the concept of sparing these drugs is well advocated together with judicious use of novel drugs, appropriate measures of infection control and prevention as well as in stewardship programs to curb the spread of MDR and XDR-strains in healthcare facilities.
描述碳青霉烯类药物的现有作用和在抗菌药物管理计划中节约碳青霉烯类药物的策略。
由于多种原因，在当前耐多药（MDR）流行的背景下，用其他药物替代碳青霉烯类药物似乎是一个很有趣的观点。还应仔细研究特定的算法，以更好地定义如何在经验性和靶向治疗方案中节约碳青霉烯类药物，包括联合治疗或单药治疗，目的是为大多数患者最好地使用新药，并尽快降低治疗强度。
管理计划可能有助于减少抗生素的不合理使用和过度使用，这可能导致了全球碳青霉烯类耐药菌的出现。因此，提出了节约碳青霉烯类药物的策略，这引起了大量的科学争论，总的来说，节约这些药物的概念以及合理使用新型药物、适当的感染控制和预防措施以及管理计划，以遏制耐多药和广泛耐药菌株在医疗机构中的传播，这一概念得到了广泛的支持。
