Journal
ARCHIVES OF MEDICAL RESEARCH
Volume 52, Issue 8, Pages 817-827Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.arcmed.2021.09.002
Keywords
ESBL; CRE; A. baumannii; Gram negative bacteria; antibiotic resistant; empirical therapy
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The article discusses the global increase in isolation of multidrug-resistant Gram-negative bacteria and the challenges in providing effective therapy using old antibiotics. It emphasizes the importance of establishing appropriate clinical and therapeutic recommendations for the antibiotic treatment of these pathogens.
During the last decades, the isolation of multidrug-resistant Gram-negative (MDR-GN) bacteria has dramatically increased worldwide and has been associated with significant delays in the administration of adequate antibiotic treatment, resulting in increased morbidity and mortality rates. Given specific challenges to effective therapy with old antibiotics, there is the need to establish adequate clinical and therapeutic recommendations for antibiotic treatment of MDR-GN pathogens. Herein, we will review risk factors for harbouring infections due to MDR-GN bacteria, proposing an algorithm for the choice of empirical treatment when a MDR-GN pathogen is suspected. In addition, we will report our recommendations regarding the first- and second-line treatment options for hospitalized patients with serious infections caused by extended-spectrum beta-lactamases producing Enterobacterales, carbapenem-resistant Enterobacterales, MDR Pseudomonas aeruginosa and MDR Acinetobacter baumannii. Recommendations have been specially focused, for each pathogen, on bloodstream infections, nosocomial pneumonia, and urinary tract infections. (C) 2021 Published by Elsevier Inc. on behalf of Instituto Mexicano del Seguro Social (IMSS).
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