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Current options for the treatment of infections due to extended-spectrum beta-lactamase-producing Enterobacteriaceae in different groups of patients.
Clin Microbiol Infect. 2019 Apr 12;:
Authors: Gutierrez-Gutiérrez B, Rodríguez-Baño J
Abstract
BACKGROUND: Extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) are a frequent cause of invasive infections worldwide. Carbapenems are nowadays the most used drugs to treat these infections. However, due to the increasing rates of resistance to these antimicrobials, carbapenem-sparing alternatives are being investigated.
OBJECTIVES: and sources: The aim of this narrative literature review is to summarise the published information on the currently available antibiotics for the treatment of ESBL-E infections, providing specific information on three subgroups of patients: group 1, patients with severe infections or infections from high-risk sources or in severely immunocompromised patients; group 2, patients with non-severe infections from intermediate-risk source; and group 3, patients with non-severe urinary tract infection.
CONTENT AND IMPLICATIONS: For patients in group 1, the current data would support the use of carbapenems. For milder infections, however, particularly urinary tract infections, other non-carbapenem antibiotics can be considered in selected cases, including beta-lactam/beta-lactam inhibitor combinations, cephaymicins temocillin and aminoglycosides. While specific studies should be performed in these situations, individualised decisions may be taken in order to avoid overuse of carbapenems.
PMID: 30986558 [PubMed - as supplied by publisher]