Yusuf Erlangga, Bax Hannelore I, Verkaik Nelianne J, van Westreenen Mireille
Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands.
J Clin Med. 2021 Mar 4;10(5):1068. doi: 10.3390/jcm10051068.
Infections in the ICU are often caused by Gram-negative bacteria. When these microorganisms are resistant to third-generation cephalosporines (due to extended-spectrum (ESBL) or AmpC beta-lactamases) or to carbapenems (for example carbapenem producing Enterobacteriales (CPE)), the treatment options become limited. In the last six years, fortunately, there have been new antibiotics approved by the U.S. Food and Drug Administration (FDA) with predominant activities against Gram-negative bacteria. We aimed to review these antibiotics: plazomicin, eravacycline, temocillin, cefiderocol, ceftazidime/avibactam, ceftolozane/tazobactam, meropenem/vaborbactam, and imipenem/relebactam. Temocillin is an antibiotic that was only approved in Belgium and the UK several decades ago. We reviewed the in vitro activities of these new antibiotics, especially against ESBL and CPE microorganisms, potential side effects, and clinical studies in complicated urinary tract infections (cUTI), intra-abdominal infections (cIAI), and hospital-acquired pneumonia/ventilator-associatedpneumonia (HAP/VAP). All of these new antibiotics are active against ESBL, and almost all of them are active against CPE caused by KPC beta-lactamase, but only some of them are active against CPE due to MBL or OXA beta-lactamases. At present, all of these new antibiotics are approved by the U.S. Food and Drug Administration for cUTI (except eravacycline) and most of them for cIAI (eravacycline, ceftazidime/avibactam, ceftolozane/tazobactam, and imipenem/relebactam) and for HAP or VAP (cefiderocol, ceftazidime/avibactam, ceftolozane/tazobactam, and imipenem/relebactam).
重症监护病房（ICU）的感染通常由革兰氏阴性菌引起。当这些微生物对第三代头孢菌素（由于超广谱β-内酰胺酶[ESBL]或AmpCβ-内酰胺酶）或碳青霉烯类药物耐药时（例如产碳青霉烯类肠杆菌科细菌[CPE]），治疗选择就会变得有限。幸运的是，在过去六年中，美国食品药品监督管理局（FDA）已批准了多种新型抗生素，这些抗生素对革兰氏阴性菌具有主要活性。我们旨在对这些抗生素进行综述：普拉佐米星、依拉环素、替莫西林、头孢地尔、头孢他啶/阿维巴坦、头孢洛扎/他唑巴坦、美罗培南/法硼巴坦以及亚胺培南/瑞来巴坦。替莫西林是一种几十年前仅在比利时和英国获批的抗生素。我们综述了这些新型抗生素的体外活性，尤其是对ESBL和CPE微生物的活性、潜在副作用，以及在复杂性尿路感染（cUTI）、腹腔内感染（cIAI）和医院获得性肺炎/呼吸机相关性肺炎（HAP/VAP）方面的临床研究。所有这些新型抗生素对ESBL均有活性，并且几乎所有抗生素对由KPCβ-内酰胺酶引起的CPE都有活性，但只有其中一些对由金属β-内酰胺酶（MBL）或OXAβ-内酰胺酶引起的CPE有活性。目前，所有这些新型抗生素均已获得美国食品药品监督管理局批准用于治疗cUTI（依拉环素除外），大多数可用于治疗cIAI（依拉环素、头孢他啶/阿维巴坦、头孢洛扎/他唑巴坦以及亚胺培南/瑞来巴坦）以及HAP或VAP（头孢地尔、头孢他啶/阿维巴坦、头孢洛扎/他唑巴坦以及亚胺培南/瑞来巴坦）。
