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用于治疗儿童多重耐药革兰氏阴性菌感染的新型β-内酰胺类抗生素:一项叙述性综述

Novel Beta Lactam Antibiotics for the Treatment of Multidrug-Resistant Gram-Negative Infections in Children: A Narrative Review.

作者信息

Venuti Francesco, Romani Lorenza, De Luca Maia, Tripiciano Costanza, Palma Paolo, Chiriaco Maria, Finocchi Andrea, Lancella Laura

机构信息

Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Amedeo di Savoia Hospital, 10149 Torino, Italy.

Infectious Disease Unit, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy.

出版信息

Microorganisms. 2023 Jul 13;11(7):1798. doi: 10.3390/microorganisms11071798.

Abstract

Infections due to carbapenem-resistant Enterobacterales (CRE) are increasingly prevalent in children and are associated with poor clinical outcomes, especially in critically ill patients. Novel beta lactam antibiotics, including ceftolozane-tazobactam, ceftazidime-avibactam, meropenem-vaborbactam, imipenem-cilastatin-relebactam, and cefiderocol, have been released in recent years to face the emerging challenge of multidrug-resistant (MDR) Gram-negative bacteria. Nonetheless, several novel agents lack pediatric indications approved by the Food and Drug Administration (FDA) and the European Medicine Agency (EMA), leading to uncertain pediatric-specific treatment strategies and uncertain dosing regimens in the pediatric population. In this narrative review we have summarized the available clinical and pharmacological data, current limitations and future prospects of novel beta lactam antibiotics in the pediatric population.

摘要

耐碳青霉烯类肠杆菌科细菌(CRE)感染在儿童中日益普遍,且与不良临床结局相关,尤其是在重症患者中。近年来,新型β-内酰胺类抗生素,包括头孢洛扎-他唑巴坦、头孢他啶-阿维巴坦、美罗培南-法硼巴坦、亚胺培南-西司他丁-雷利巴坦和头孢地尔,已被推出以应对多重耐药(MDR)革兰氏阴性菌这一新兴挑战。尽管如此,几种新型药物缺乏美国食品药品监督管理局(FDA)和欧洲药品管理局(EMA)批准的儿科适应症,导致儿科特定治疗策略和儿科人群给药方案不确定。在这篇叙述性综述中,我们总结了新型β-内酰胺类抗生素在儿科人群中的现有临床和药理学数据、当前局限性及未来前景。

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