Wong Darren W
Division of Infectious Diseases, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
Antibiotics (Basel). 2024 Aug 14;13(8):766. doi: 10.3390/antibiotics13080766.
Carbapenem-resistant Enterobacteriaceae infections are a considerable challenge for clinicians. In recent years, novel antibiotic options have resulted in a tremendous advance in medical therapy; however, current treatment options are primarily effective for resistance derived from serine-based carbapenemases. The Ambler class B metallo-β-lactamases (MBLs) remain a critical challenge with decidedly fewer effective options. One intriguing option for these MBL pathogens is the combination of ceftazidime-avibactam with aztreonam. While clinical experience with this regimen is limited, in vitro studies are promising, and limited case reports describe success with this regimen; however, significant challenges preclude widespread adoption of this novel treatment regimen. A systemic literature review was performed to offer recommendations based on current evidence for a practical strategy on how to best integrate the use of aztreonam with avibactam combination therapy.
耐碳青霉烯类肠杆菌科细菌感染对临床医生来说是一个巨大的挑战。近年来，新型抗生素的出现使药物治疗取得了巨大进展；然而，目前的治疗选择主要对丝氨酸类碳青霉烯酶介导的耐药有效。安布勒B类金属β-内酰胺酶（MBLs）仍然是一个严峻的挑战，有效的治疗选择明显较少。对于这些产MBL的病原体，一个引人关注的选择是头孢他啶-阿维巴坦与氨曲南联合使用。虽然该方案的临床经验有限，但体外研究很有前景，且有限的病例报告描述了该方案取得的成功；然而，重大挑战阻碍了这种新型治疗方案的广泛应用。我们进行了一项系统性文献综述，以根据现有证据就如何最佳整合氨曲南与阿维巴坦联合治疗的实用策略提供建议。
