School of Pharmacy, University of Wisconsin-Madison, Madison, Wisconsin, USA.
Pharmacy Department, Sharp Memorial Hospital, San Diego, California, USA.
Clin Infect Dis. 2021 Dec 16;73(12):2353-2360. doi: 10.1093/cid/ciab452.
The last several years have seen an emergence of literature documenting the utility of combination antimicrobial therapy, particularly in the salvage of refractory methicillin-resistant Staphylococcus aureus (MRSA) bacteremia. Recent clinical data are shaping conundrums of which regimens may be more beneficial, which can be potentially harmful, and which subset of patients stand to benefit from more aggressive treatment regimens than called for by current standards. In addition, the incorporation of combination therapy for MRSA bacteremia should be accompanied by the reminder that antimicrobial therapy does not need to be uniform for the entire duration, with an early intensive phase in high inoculum infections (eg, with combination therapy), followed by a consolidation phase (ie, monotherapy). This review and perspective consolidates the recent data on this subject and directs future goals in filling the knowledge gaps to methodically move forward towards improving patient outcomes.
过去几年的文献表明，联合抗菌治疗，尤其是在挽救耐甲氧西林金黄色葡萄球菌（MRSA）菌血症方面具有一定作用。最近的临床数据提出了一些难题，例如哪些方案可能更有益，哪些可能有害，以及哪些亚组患者可能从比现行标准更积极的治疗方案中获益。此外，对于 MRSA 菌血症的联合治疗，还应提醒人们，抗菌治疗并不需要在整个治疗过程中保持一致，在高接种量感染（如联合治疗）的早期强化阶段之后，进行巩固阶段（即单药治疗）。本综述和观点整合了该主题的最新数据，并为填补知识空白确定了未来目标，以有系统地朝着改善患者预后的方向前进。
