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在肾功能受损的患者中,对于多重耐药/广泛耐药铜绿假单胞菌引起的复杂性皮肤软组织感染,头孢他洛/他唑巴坦作为治疗选择的疗效和安全性:一项来自单中心经验的病例系列研究。

Efficacy and safety of ceftolozane/tazobactam as therapeutic option for complicated skin and soft tissue infections by MDR/XDR Pseudomonas aeruginosa in patients with impaired renal function: a case series from a single-center experience.

机构信息

Department of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples "Federico II", Naples, Italy.

出版信息

Infection. 2020 Apr;48(2):303-307. doi: 10.1007/s15010-020-01390-y. Epub 2020 Jan 24.

Abstract

INTRODUCTION

Pseudomonas aeruginosa (PA) is a known cause of skin and soft tissue infections (SSTIs). Therapeutic options against multidrug-resistant (MDR) and extensively drug-resistant (XDR) strains of PA are limited, especially in patients with impaired renal function. Ceftolozane/tazobactam (C/T) is a novel beta-lactam/beta-lactamase inhibitor with powerful anti-PA activity. Thanks to its characteristics, it appears to be the best available anti-pseudomonal drug in many clinical scenarios. A case series of four adult patients followed between January 2018 and May 2019 is reported. All subjects presented complicated SSTIs by MDR- or XDR-PA and were affected by chronic kidney disease.

RESULTS

C/T was used as a monotherapy in three cases and in combination regimen in the remaining case. In two cases, C/T was the first-line option, in the remaining ones was the salvage treatment. All patients were successfully treated without worsening of renal function and without any other adverse events.

CONCLUSIONS

C/T may represent a useful option against MDR- and XDR-PA strains responsible of complicated SSTIs in patients affected by impaired renal function.

摘要

简介

铜绿假单胞菌(PA)是一种已知的皮肤和软组织感染(SSTIs)的病原体。针对多药耐药(MDR)和广泛耐药(XDR)铜绿假单胞菌菌株的治疗选择有限,特别是在肾功能受损的患者中。头孢他啶/他唑巴坦(C/T)是一种新型的β-内酰胺/β-内酰胺酶抑制剂,对铜绿假单胞菌具有强大的抗菌活性。由于其特性,它在许多临床情况下似乎是最可用的抗假单胞菌药物。报告了 2018 年 1 月至 2019 年 5 月期间随访的 4 例成年患者的病例系列。所有患者均患有由 MDR 或 XDR-PA 引起的复杂 SSTIs,并患有慢性肾脏病。

结果

C/T 在三种情况下作为单药治疗,在剩余一种情况下作为联合治疗方案使用。在两种情况下,C/T 是一线治疗选择,在其余情况下是挽救性治疗。所有患者均成功治疗,肾功能无恶化,无其他不良事件。

结论

C/T 可能是治疗由肾功能受损患者的复杂 SSTIs 引起的 MDR 和 XDR-PA 菌株的有效选择。

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