Journal
CLINICAL MICROBIOLOGY AND INFECTION
Volume 25, Issue 8, Pages 932-942Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.cmi.2019.03.030
Keywords
Bloodstream infections; Carbapenems; Extended-spectrum beta-lactamases; Mortality; Treatment; Urinary tract Infections
Categories
Funding
- MSD
- Plan Nacional de I+D+i 2013-2016
- Instituto de Salud Carlos III, Subdireccion General de Redes y Centros de Investigacion Cooperativa, Ministerio de Ciencia, Innovacion y Universidades, Spanish Network for Research in Infectious Diseases - European Development Regional Fund 'A way to achie [REIPI RD16/0016/0001]
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Background: Extended-spectrum beta-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 summarize 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, cephamycins, temocillin and aminoglycosides. While specific studies should be performed in these situations, individualized decisions may be taken in order to avoid overuse of carbapenems. (C) 2019 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
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