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Antibiotic therapy for inducible AmpC β-lactamase-producing Gram-negative bacilli: what are the alternatives to carbapenems, quinolones and aminoglycosides?

Harris, P.N.A ; Ferguson, J.K

International journal of antimicrobial agents, 2012-10, Vol.40 (4), p.297-305 [Periódico revisado por pares]

Amsterdam: Elsevier B.V

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Título:
Antibiotic therapy for inducible AmpC β-lactamase-producing Gram-negative bacilli: what are the alternatives to carbapenems, quinolones and aminoglycosides?
Autor: Harris, P.N.A ; Ferguson, J.K
Assuntos: aminoglycosides ; Aminoglycosides - pharmacology ; Aminoglycosides - therapeutic use ; Anti-Bacterial Agents - pharmacology ; Anti-Bacterial Agents - therapeutic use ; Antibiotics. Antiinfectious agents. Antiparasitic agents ; bacteremia ; Bacterial Proteins - secretion ; beta-lactamase ; beta-Lactamases - secretion ; Biological and medical sciences ; carbapenems ; Carbapenems - pharmacology ; Carbapenems - therapeutic use ; Cefepime ; Cefotaxime ; Ceftriaxone ; cephalosporins ; Citrobacter ; Citrobacter freundii ; clinical trials ; Drug Resistance, Multiple, Bacterial ; drugs ; Enterobacter ; Enterobacteriaceae - drug effects ; Enterobacteriaceae - enzymology ; Enterobacteriaceae - isolation & purification ; Enterobacteriaceae Infections - drug therapy ; Enterobacteriaceae Infections - microbiology ; Gram-negative bacteria ; Humans ; Infectious Disease ; Medical sciences ; meningitis ; Morganella morganii ; mutants ; Pharmacology. Drug treatments ; piperacillin ; Piperacillin/tazobactam ; Providencia ; quinolones ; Quinolones - pharmacology ; Quinolones - therapeutic use ; risk ; Serratia ; Serratia marcescens ; sulfamethoxazole ; therapeutics ; toxicity ; trimethoprim ; Trimethoprim/sulfamethoxazole
É parte de: International journal of antimicrobial agents, 2012-10, Vol.40 (4), p.297-305
Notas: http://dx.doi.org/10.1016/j.ijantimicag.2012.06.004
Descrição: Some bacteria that possess chromosomally determined AmpC β-lactamases may express these enzymes at a high level following exposure to β-lactams, either by induction or selection for derepressed mutants. This may lead to clinical failure even if an isolate initially tests susceptible in vitro, a phenomenon best characterised by third-generation cephalosporin therapy for Enterobacter bacteraemia or meningitis. Several other Enterobacteriaceae, such as Serratia marcescens, Citrobacter freundii, Providencia spp. and Morganella morganii (often termed the ‘ESCPM’ group), may also express high levels of AmpC. However, the risk of clinical failure with β-lactams that test susceptible in vitro is less clear in these species than for Enterobacter. Laboratories frequently do not report β-lactam or β-lactamase inhibitor combination drug susceptibilities for ESCPM organisms, encouraging alternative therapy with quinolones, aminoglycosides or carbapenems. However, quinolones and carbapenems present problems with selective pressure for multiresistant organisms, and aminoglycosides with potential toxicity. The risk of emergent AmpC-mediated resistance for non-Enterobacter spp. appears rare in clinical studies. Piperacillin/tazobactam may remain effective and may be less selective for AmpC derepressed mutants than cephalosporins. The potential roles for agents such as cefepime or trimethoprim/sulfamethoxazole are also discussed. Clinical studies that better define optimal treatment for this group of bacteria are required.
Editor: Amsterdam: Elsevier B.V
Idioma: Inglês

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Antibiotic therapy for inducible AmpC β-lactamase-producing Gram-negative bacilli: what are the alternatives to carbapenems, quinolones and aminoglycosides?

Harris, P.N.A ; Ferguson, J.K

Amsterdam: Elsevier B.V

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