[Resistant gram-negative bacteria. Therapeutic approach and risk factors].
The rapid spread of multidrug-resistant bacteria has become a serious threat, especially in critical care units, thereby prolonging the hospital stay. Enterobacteriaceae have a high capacity to adapt to any environment. Plasmids are the reason behind their expansion. The choice of empiric therapy for intra-abdominal or urinary infections requires knowledge of the intrinsic microbiological variability of each hospital or critical care unit, as well as the source of infection, safety or antibiotic toxicity, interaction with other drugs, the dosage regimen and the presence of risk factors. Carbapenems are the drug of choice in the case of suspected infection by ESBL-producing Enterobacteriaceae. The new ceftazidime/avibactam and ceftolozane/tazobactam drugs are opening up promising new horizons in the treatment of multidrug-resistant Enterobacteriaceae.
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Emilio Maseda, Servicio de Anestesia y Reanimación, Hospital Universitario La Paz. Paseo de la Castellana 261; 28046, Madrid, Spain. emilio.maseda@gmail.com.
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D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics; D004755:Enterobacteriaceae / Q000187:drug effects / Q000235:genetics; D004756:Enterobacteriaceae Infections / Q000235:genetics / Q000382:microbiology; D006090:Gram-Negative Bacteria / Q000187:drug effects* / Q000235:genetics; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology*; D006801:Humans; D010957:Plasmids / Q000235:genetics; D012307:Risk Factors
D000900:Anti-Bacterial Agents