Romanelli Federica, De Robertis Annalisa, Carone Gianluca, Dalfino Lidia, Stufano Monica, Del Prete Raffaele, Mosca Adriana
Section of Microbiology, Interdisciplinary Department of Medicine (DIM), School of Medicine, University of Bari, Italy.
Anesthesia and Intensive Care Unit, Department of Emergency and Organ Transplantation, University of Bari, Italy.
New Microbiol. 2020 Jul;43(3):136-138. Epub 2020 Jun 29.
KPC-producing Klebsiella pneumonia (KPC-Kp) represents a major therapeutic challenge in critically ill patients. Ceftazidime-avibactam (CAZ-AVI) is a new effective drug against KPC-Kp but, due to emerging resistant strains during monotherapy, the association with a second antibiotic has been advocated. Therefore, intravenous fosfomycin may be a possible choice for combination therapy. The aim of this study was to evaluate the in vitro susceptibility of CAZ-AVI alone and in combination with fosfomycin and carbapenems against KPC-Kp clinical isolates by E-test method. The combination of CAZ-AVI with carbapenems showed synergistic activity, whereas with fosfomycin showed addictive activity, suggesting that fosfomycin may be a carbapenem-sparing strategy in antimicrobial stewardship programs.
产KPC的肺炎克雷伯菌（KPC-Kp）对重症患者构成了重大治疗挑战。头孢他啶-阿维巴坦（CAZ-AVI）是一种针对KPC-Kp的新型有效药物，但由于单药治疗期间出现耐药菌株，有人主张将其与第二种抗生素联合使用。因此，静脉注射磷霉素可能是联合治疗的一种选择。本研究的目的是通过E-test法评估CAZ-AVI单独使用以及与磷霉素和碳青霉烯类联合使用时对KPC-Kp临床分离株的体外敏感性。CAZ-AVI与碳青霉烯类联合使用显示出协同活性，而与磷霉素联合使用显示出相加活性，这表明在抗菌管理计划中，磷霉素可能是一种减少碳青霉烯类使用的策略。
