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Tytuł:
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A Critical Evaluation of Newer β-Lactam Antibiotics for Treatment of Pseudomonas aeruginosa Infections.
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Autorzy:
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Blomquist KC; Department of Pharmacy Practice & Science, University of Arizona, Tucson, Arizona, USA.
Nix DE; Department of Pharmacy Practice & Science, University of Arizona, Tucson, Arizona, USA.; Department of Medicine, Division of Infectious Diseases, University of Arizona, Tucson, Arizona, USA.
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Źródło:
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The Annals of pharmacotherapy [Ann Pharmacother] 2021 Aug; Vol. 55 (8), pp. 1010-1024. Date of Electronic Publication: 2020 Nov 23.
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Typ publikacji:
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Journal Article; Review
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Język:
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English
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Imprint Name(s):
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Publication: Sept. 2013- : Thousand Oaks, CA : Sage
Original Publication: Cincinnati, OH : Harvey Whitney Books Co., c1992-
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MeSH Terms:
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Pseudomonas Infections*/drug therapy
Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Cephalosporins ; Drug Combinations ; Drug Resistance, Multiple, Bacterial ; Humans ; Microbial Sensitivity Tests ; Pseudomonas aeruginosa
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Contributed Indexing:
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Keywords: Pseudomonas aeruginosa; avibactam; cefiderocol; ceftazidime; ceftolozane; drug combination; relebactam; vaborbactam; β-lactamases
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Substance Nomenclature:
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0 (Anti-Bacterial Agents)
0 (Cephalosporins)
0 (Drug Combinations)
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Entry Date(s):
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Date Created: 20201124 Date Completed: 20210906 Latest Revision: 20210906
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Update Code:
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20240105
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DOI:
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10.1177/1060028020974003
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PMID:
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33228374
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Objective: This article critically evaluates common Pseudomonas aeruginosa resistance mechanisms and the properties newer β-lactam antimicrobials possess to evade these mechanisms.
Data Sources: An extensive PubMed, Google Scholar, and ClinicalTrials.gov search was conducted (January 1995 to July 2020) to identify relevant literature on epidemiology, resistance mechanisms, antipseudomonal agents, newer β-lactam agents, and clinical data available pertaining to P aeruginosa .
Study Selection and Data Extraction: Relevant published articles and package inserts were reviewed for inclusion.
Data Synthesis: Therapeutic options to treat P aeruginosa infections are limited because of its intrinsic and acquired resistance mechanisms. The goal was to identify advances with newer β-lactams and characterize improvements in therapeutic potential for P aeruginosa infections.
Relevance to Patient Care and Clinical Practice: Multidrug-resistant (MDR) P aeruginosa isolates are increasingly encountered from a variety of infections. This review highlights potential activity gains of newer β-lactam antibacterial drugs and the current clinical data to support their use. Pharmacists will be asked to recommend or evaluate the use of these agents and need to be aware of information specific to P aeruginosa , which differs from experience derived from Enterobacterales infections.
Conclusions: Newer agents, including ceftazidime-avibactam, ceftolozane-tazobactam, imipenem-relebactam, and cefiderocol, are useful for the treatment of MDR P aeruginosa infections. These agents offer improved efficacy and less toxicity compared with aminoglycosides and polymyxins and can be used for pathogens that are resistant to first-line antipseudomonal β-lactams. Selection of one agent over another should consider availability, turnaround of susceptibility testing, and product cost. Efficacy data specific for pseudomonal infections are limited, and there are no direct comparisons between the newer agents.
