Department of Intensive Care Medicine, Multidisciplinary Intensive Care Research Organization (MICRO) and Department of Clinical Medicine, Trinity College, Wellcome Trust-HRB Clinical Research Facility , Dublin, Ireland.
Hospital de Barcelona, IDIBAPS, CIBERes , Barcelona, Spain.
Expert Rev Anti Infect Ther. 2020 Dec;18(12):1177-1185. doi: 10.1080/14787210.2020.1794816. Epub 2020 Jul 21.
Patients admitted to hospitals are at risk of developing nosocomial infections. These types of infections typically occur in immune-compromised patients. Furthermore, nosocomial infections are frequently caused by resistant organisms, including nonfermenting gram-negative bacilli such as .
is a hazardous pathogen. It can resist numerous antibiotics, due to several resistance mechanisms. It is associated with serious illnesses, particularly hospital-acquired infections including ventilator-associated pneumonia. In the past, only a limited number of anti-pseudomonal drugs were available. However, several therapeutic advancements have been made, in recent years, to target , including the development of the new cephalosporin: ceftolozane-tazobactam.
Ceftolozane-tazobactam is a combination of a novel semi-synthetic fifth-generation cephalosporin with a well-established beta-lactamase inhibitor. From a structural perspective, ceftolozane-tazobactam has attested increased stability to AmpC β-lactamases. Additionally, ceftolozane-tazobactam is less affected by changes in efflux pumps and porin permeability due to an enhanced affinity to certain penicillin-binding proteins (PBPs). This enables the molecule to overcome the most common anti-drug resistant mechanisms of bacteria. According to previous clinical trials conducted, ceftolozane-tazobactam must be considered when treating patients with confirmed or suspected respiratory tract infections, either nosocomial pneumonia or ventilator-associated pneumonia.
住院患者有发生医院获得性感染的风险。这类感染通常发生在免疫功能低下的患者中。此外，医院获得性感染通常由耐药菌引起，包括非发酵革兰氏阴性杆菌，如 。
是一种危险的病原体。由于存在几种耐药机制，它可以抵抗多种抗生素。它与严重疾病有关，特别是医院获得性感染，包括呼吸机相关性肺炎。过去，只有少数几种抗假单胞菌药物可用。然而，近年来，已经针对 取得了一些治疗进展，包括新型头孢菌素：头孢洛扎坦-他唑巴坦的开发。
头孢洛扎坦-他唑巴坦是一种新型半合成第五代头孢菌素与一种成熟的β-内酰胺酶抑制剂的组合。从结构上看，头孢洛扎坦-他唑巴坦对 AmpC β-内酰胺酶的稳定性得到了证实。此外，由于与某些青霉素结合蛋白（PBPs）的亲和力增强，头孢洛扎坦-他唑巴坦受外排泵和孔道通透性变化的影响较小。这使该分子能够克服细菌最常见的抗药性耐药机制。根据之前进行的临床试验，当治疗确诊或疑似 呼吸道感染（无论是医院获得性肺炎还是呼吸机相关性肺炎）的患者时，必须考虑使用头孢洛扎坦-他唑巴坦。
