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Therapy of Infections due to Carbapenem-Resistant Gram-Negative Pathogens

The prevalence of carbapenem-resistant gram-negative bacterial pathogens (CRGNs) has increased dramatically during the last 10 years, but the optimal treatment for CRGN infections is not well established due to the relative scarcity of robust clinical data. The polymyxins remain the most consistentl...

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Autores principales: Lee, Chang-Seop, Doi, Yohei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society of Infectious Diseases and Korean Society for Chemotherapy 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4189141/
https://www.ncbi.nlm.nih.gov/pubmed/25298904
http://dx.doi.org/10.3947/ic.2014.46.3.149
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author Lee, Chang-Seop
Doi, Yohei
author_facet Lee, Chang-Seop
Doi, Yohei
author_sort Lee, Chang-Seop
collection PubMed
description The prevalence of carbapenem-resistant gram-negative bacterial pathogens (CRGNs) has increased dramatically during the last 10 years, but the optimal treatment for CRGN infections is not well established due to the relative scarcity of robust clinical data. The polymyxins remain the most consistently active agents against CRGNs in vitro. Tigecycline, based on its in vitro antibacterial spectrum, could also be considered as a therapeutic option in the treatment of infections caused by certain CRGNs. Other agents, including aminoglycosides, rifampin, trimethoprim-sulfamethoxazole, fosfomycin and fluoroquinolones, could be considered as monotherapy or combination therapy against CRGNs in appropriate contexts, as combination therapy with two or more in vitro active drugs appears to be more effective than monotherapy based on some clinical data. Several promising new agents are in late-stage clinical development, including ceftolozane-tazobactam, ceftazidime-avibactam and plazomicin. Given the shortage of adequate treatment options, containment of CRGNs should be pursued through implementation of adequate infection prevention procedures and antimicrobial stewardship to reduce the disease burden and prevent future outbreaks of CRGNs.
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spelling pubmed-41891412014-10-08 Therapy of Infections due to Carbapenem-Resistant Gram-Negative Pathogens Lee, Chang-Seop Doi, Yohei Infect Chemother Review Article The prevalence of carbapenem-resistant gram-negative bacterial pathogens (CRGNs) has increased dramatically during the last 10 years, but the optimal treatment for CRGN infections is not well established due to the relative scarcity of robust clinical data. The polymyxins remain the most consistently active agents against CRGNs in vitro. Tigecycline, based on its in vitro antibacterial spectrum, could also be considered as a therapeutic option in the treatment of infections caused by certain CRGNs. Other agents, including aminoglycosides, rifampin, trimethoprim-sulfamethoxazole, fosfomycin and fluoroquinolones, could be considered as monotherapy or combination therapy against CRGNs in appropriate contexts, as combination therapy with two or more in vitro active drugs appears to be more effective than monotherapy based on some clinical data. Several promising new agents are in late-stage clinical development, including ceftolozane-tazobactam, ceftazidime-avibactam and plazomicin. Given the shortage of adequate treatment options, containment of CRGNs should be pursued through implementation of adequate infection prevention procedures and antimicrobial stewardship to reduce the disease burden and prevent future outbreaks of CRGNs. The Korean Society of Infectious Diseases and Korean Society for Chemotherapy 2014-09 2014-09-24 /pmc/articles/PMC4189141/ /pubmed/25298904 http://dx.doi.org/10.3947/ic.2014.46.3.149 Text en Copyright © 2014 by The Korean Society of Infectious Diseases and Korean Society for Chemotherapy http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Lee, Chang-Seop
Doi, Yohei
Therapy of Infections due to Carbapenem-Resistant Gram-Negative Pathogens
title Therapy of Infections due to Carbapenem-Resistant Gram-Negative Pathogens
title_full Therapy of Infections due to Carbapenem-Resistant Gram-Negative Pathogens
title_fullStr Therapy of Infections due to Carbapenem-Resistant Gram-Negative Pathogens
title_full_unstemmed Therapy of Infections due to Carbapenem-Resistant Gram-Negative Pathogens
title_short Therapy of Infections due to Carbapenem-Resistant Gram-Negative Pathogens
title_sort therapy of infections due to carbapenem-resistant gram-negative pathogens
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4189141/
https://www.ncbi.nlm.nih.gov/pubmed/25298904
http://dx.doi.org/10.3947/ic.2014.46.3.149
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