UQ Centre for Clinical Research, Faculty of Medicine, University of Queensland, Brisbane, QLD 4029, Australia; Department of Pharmacy, College of medicine and health Sciences,Debre Markos University, Debre Markos, Ethiopia.
UQ Centre for Clinical Research, Faculty of Medicine, University of Queensland, Brisbane, QLD 4029, Australia; Herston Infectious Diseases Institute (HeIDI), Metro North Health, Brisbane, QLD, Australia; Departments of Pharmacy and Intensive Care Medicine, Royal Brisbane and Women's Hospital, Brisbane, QLD 4029, Australia; Division of Anaesthesiology Critical Care Emergency and Pain Medicine, Nîmes University Hospital, University of Montpellier, 30029 Nîmes, France.
J Infect. 2024 Nov;89(5):106299. doi: 10.1016/j.jinf.2024.106299. Epub 2024 Sep 30.
To review the literature on parenteral carbapenems in OPAT and present comprehensive evidence on their safety, efficacy, and stability.
A systematic review following PRISMA guidelines was conducted through 17 January 2024, using PubMed, Embase, Web of Science, Scopus, and the Cochrane Library to find relevant articles.
Ertapenem (1 g QD) in OPAT showed high clinical (81-97%) and microbiological (67-90.9%) success rates. Ertapenem (1 g QD) was also comparable to piperacillin/tazobactam (3.375 g every 6 h) for complicated skin infections and superior to cefazolin (2 g every 8 h) and oxacillin (2 g every 4-6 h) for various infections. Ertapenem monotherapy, once daily, achieved an 81% clinical cure rate for urinary tract infections. Additionally, subcutaneous ertapenem in OPAT showed outcomes comparable to parenteral routes. Meropenem continuous infusion (CI) may also be considered safe and effective in selected patient populations; however, its use in OPAT as a CI is limited due to stability concerns.
Parenteral carbapenems are effective, and well-tolerated OPAT treatment options; nonetheless, further studies are warranted to optimize the stability and/or dosing regimens of meropenem and enable its wider use.
回顾静脉用碳青霉烯类药物在门诊抗生素治疗（OPAT）中的文献，并提供关于其安全性、疗效和稳定性的综合证据。
通过系统评价，按照 PRISMA 指南，检索 2024 年 1 月 17 日之前的 PubMed、Embase、Web of Science、Scopus 和 Cochrane 图书馆相关文章。
OPAT 中使用 1g 厄他培南（QD），临床（81-97%）和微生物学（67-90.9%）成功率高。对于复杂性皮肤感染，厄他培南（1g QD）与哌拉西林/他唑巴坦（3.375g 每 6 小时）相当，优于头孢唑林（2g 每 8 小时）和苯唑西林（2g 每 4-6 小时）用于各种感染。厄他培南单药治疗，每日一次，治疗尿路感染的临床治愈率为 81%。此外，OPAT 中的皮下注射厄他培南与静脉途径的结果相当。美罗培南持续输注（CI）在选定的患者人群中也可能被认为是安全有效的；然而，由于稳定性问题，其在 OPAT 中的 CI 应用受到限制。
静脉用碳青霉烯类药物是有效的、可耐受的 OPAT 治疗选择；然而，需要进一步的研究来优化美罗培南的稳定性和/或剂量方案，使其更广泛地应用。
