Recommendation for treatment of severe infections caused by Enterobacteriaceae producing extended-spectrum beta-lactamases (ESBLs).
Extended-spectrum beta-lactamase (ESBL)-producing organisms are a global problem. No randomized controlled trials have ever been performed to guide optimal treatment. However, in vitro studies and observational studies strongly suggest that carbapenems (imipenem or meropenem) should be regarded as drugs of choice for serious infections due to ESBL-producing organisms. Other beta-lactam antibiotics (cefepime, beta-lactam/beta-lactamase inhibitor combinations) are not suitable as first-line therapy. The increasing frequency of the association between quinolone resistance and ESBL production have greatly limited the role of this class of antibiotic against ESBL producers.
Paterson
D L
DL
Infectious Disease Section, Instituto per I Trapianti Terapie as Alta Specializzazione, Palermo, Italy. patersondl@hotmail.com
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D015780:Carbapenems / Q000627:therapeutic use; D002511:Cephalosporins / Q000627:therapeutic use; D004755:Enterobacteriaceae / Q000201:enzymology* / Q000254:growth & development; D004756:Enterobacteriaceae Infections / Q000188:drug therapy*; D006801:Humans; D001618:beta-Lactamases / Q000096:biosynthesis / Q000378:metabolism*
D000900:Anti-Bacterial Agents; D015780:Carbapenems; D002511:Cephalosporins; D001618:beta-Lactamases