Treatment options for carbapenem-resistant and extensively drug-resistant Acinetobacter baumannii infections

J. Alexander Viehman, M. Hong Nguyen, Yohei Doi

研究成果: Review article査読

144 被引用数 (Scopus)

抄録

Acinetobacter baumannii is a leading cause of healthcare-associated infections worldwide. Because of various intrinsic and acquired mechanisms of resistance, most β-lactam agents are not effective against many strains, and carbapenems have played an important role in therapy. Recent trends show many infections are caused by carbapenem-resistant or even extensively drug-resistant (XDR) strains, for which effective therapy is not well established. Evidence to date suggests that colistin constitutes the backbone of therapy, but the unique pharmacokinetic properties of colistin have led many to suggest the use of combination antimicrobial therapy. However, the combination of agents and dosing regimens that delivers the best clinical efficacy while minimizing toxicity is yet to be defined. Carbapenems, sulbactam, rifampin and tigecycline have been the most studied in the context of combination therapy. Most data regarding therapy for invasive, resistant A. baumannii infections come from uncontrolled case series and retrospective analyses, though some clinical trials have been completed and others are underway. Early institution of appropriate antimicrobial therapy is shown to consistently improve survival of patients with carbapenem-resistant and XDR A. baumannii infection, but the choice of empiric therapy in these infections remains an open question. This review summarizes the most current knowledge regarding the epidemiology, mechanisms of resistance, and treatment considerations of carbapenem-resistant and XDR A. baumannii.

本文言語English
ページ(範囲)1315-1333
ページ数19
ジャーナルDrugs
74
12
DOI
出版ステータスPublished - 01-08-2014
外部発表はい

All Science Journal Classification (ASJC) codes

  • 薬理学(医学)

フィンガープリント

「Treatment options for carbapenem-resistant and extensively drug-resistant Acinetobacter baumannii infections」の研究トピックを掘り下げます。これらがまとまってユニークなフィンガープリントを構成します。

引用スタイル