ESBL - from petri dish to the patient.
Treatment of extended spectrum beta-lactamase (ESBL) producing strains of Enterobacteriaceae has emerged as a major challenge in hospitalised as well as community based patients. Infections due to ESBL producers range from uncomplicated urinary tract infection to life threatening sepsis. Although several reviews have been published in the literature about the detection and identification of these pathogens in the laboratory, there is not much guidance in Indian literature about how these organisms should be treated in clinical settings. The present article tries to address the clinical questions in the management of ESBL producing organisms. The article emphasises on antibiotic choice, pharmaco-therapeutic considerations, non-antibiotic aspects of management, and testing of clinical samples in the initial screening of patients for resistant gram negative organisms.
Bhattacharya
S
S
Health Protection Agency, Heart of England NHS Trust, Bordesley Green East, Birmingham, B9 5SS, India. drsanjay1970@hotmail.com
D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D003470:Culture Media; D024881:Drug Resistance, Bacterial; D004755:Enterobacteriaceae / Q000187:drug effects / Q000201:enzymology* / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D008826:Microbial Sensitivity Tests; D017410:Practice Guidelines as Topic; D001618:beta-Lactamases / Q000096:biosynthesis*
D000900:Anti-Bacterial Agents; D003470:Culture Media; D001618:beta-Lactamases