Department of Pharmacy Practice & Science, University of Arizona, Tucson, Arizona, USA.
Department of Medicine, Division of Infectious Diseases, University of Arizona, Tucson, Arizona, USA.
Ann Pharmacother. 2021 Aug;55(8):1010-1024. doi: 10.1177/1060028020974003. Epub 2020 Nov 23.
This article critically evaluates common resistance mechanisms and the properties newer β-lactam antimicrobials possess to evade these mechanisms.
An extensive PubMed, Google Scholar, and ClinicalTrials.gov search was conducted (January 1995 to July 2020) to identify relevant literature on epidemiology, resistance mechanisms, antipseudomonal agents, newer β-lactam agents, and clinical data available pertaining to .
Relevant published articles and package inserts were reviewed for inclusion.
Therapeutic options to treat infections are limited because of its intrinsic and acquired resistance mechanisms. The goal was to identify advances with newer β-lactams and characterize improvements in therapeutic potential for infections.
Multidrug-resistant (MDR) isolates are increasingly encountered from a variety of infections. This review highlights potential activity gains of newer β-lactam antibacterial drugs and the current clinical data to support their use. Pharmacists will be asked to recommend or evaluate the use of these agents and need to be aware of information specific to , which differs from experience derived from infections.
Newer agents, including ceftazidime-avibactam, ceftolozane-tazobactam, imipenem-relebactam, and cefiderocol, are useful for the treatment of MDR infections. These agents offer improved efficacy and less toxicity compared with aminoglycosides and polymyxins and can be used for pathogens that are resistant to first-line antipseudomonal β-lactams. Selection of one agent over another should consider availability, turnaround of susceptibility testing, and product cost. Efficacy data specific for pseudomonal infections are limited, and there are no direct comparisons between the newer agents.
本文批判性地评估了常见的耐药机制，以及新型β-内酰胺类抗菌药物逃避这些机制的特性。
对PubMed、Google Scholar 和 ClinicalTrials.gov 进行了广泛的检索（1995 年 1 月至 2020 年 7 月），以确定有关流行病学、耐药机制、抗假单胞菌药物、新型β-内酰胺类药物以及与相关的临床数据的相关文献。
对相关的已发表文章和产品说明书进行了评估，以确定是否符合纳入标准。
由于其内在和获得性耐药机制，治疗 感染的治疗选择有限。本研究的目的是确定新型β-内酰胺类药物的进展，并描述其治疗 感染的治疗潜力的改善。
越来越多的各种感染中都出现了多重耐药（MDR） 分离株。这篇综述强调了新型β-内酰胺类抗菌药物的潜在活性增益以及支持其使用的当前临床数据。药剂师将被要求推荐或评估这些药物的使用，并需要了解与 感染相关的特定信息，这些信息与从 感染中获得的经验不同。
新型药物，包括头孢他啶-阿维巴坦、头孢洛扎-他唑巴坦、亚胺培南-雷利巴坦和头孢地尔，可用于治疗 MDR 感染。与氨基糖苷类和多黏菌素类药物相比，这些药物具有更好的疗效和更低的毒性，可用于对抗对一线抗假单胞菌β-内酰胺类药物耐药的病原体。选择一种药物而不是另一种药物应考虑可用性、药敏试验的周转时间和产品成本。针对假单胞菌感染的疗效数据有限，并且新型药物之间没有直接比较。
