The role of beta-lactam/beta-lactamase inhibitor combinations in surgical infections.
Many surgical infections are characterized by synergistic polymicrobial mixed infection, for which broad-spectrum antimicrobial therapy is usually administered on an empiric basis. Until relatively recently, standard empiric therapeutic regimens have involved the use of two or more antibiotics, such as aminoglycosides and anti-anaerobic agents, to achieve adequate aerobic and anaerobic coverage. There are often substantial drawbacks, however, such as drug-induced toxicity and high costs of treatment. Evidence from a number of clinical studies suggests that single-agent therapy with beta-lactam/beta-lactamase inhibitor combinations is a suitable and cost-effective alternative to multidrug regimens, as well as to monotherapy with cephalosporins or carbapenems in the treatment of intra-abdominal, gynecologic, and diabetic foot infections, and brain abscesses. These agents are also suitable for use in perioperative prophylaxis and may offer benefits over other agents in terms of reduced incidence of surgical wound infections and lower costs.
Sayek
I
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Hacettepe University School of Medicine, Ankara, Turkey. sayek@ato.org.tr
D000900:Anti-Bacterial Agents; D018849:Controlled Clinical Trials as Topic; D004359:Drug Therapy, Combination / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006090:Gram-Negative Bacteria / Q000187:drug effects; D006094:Gram-Positive Bacteria / Q000187:drug effects; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000188:drug therapy* / Q000382:microbiology; D018570:Risk Assessment; D013514:Surgical Procedures, Operative / Q000009:adverse effects / Q000379:methods; D013530:Surgical Wound Infection / Q000188:drug therapy* / Q000382:microbiology; D016896:Treatment Outcome; D065093:beta-Lactamase Inhibitors; D001618:beta-Lactamases / Q000008:administration & dosage*
D000900:Anti-Bacterial Agents; D065093:beta-Lactamase Inhibitors; D001618:beta-Lactamases