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Options for treating carbapenem-resistant Enterobacteriaceae.

Petros I Rafailidis1, Matthew E Falagas

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Combination antibiotic therapy shows promise for treating carbapenem-resistant Enterobacteriaceae infections. Regimens including carbapenems or combinations of colistin, tigecycline, aminoglycosides, and fosfomycin may improve outcomes.

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Area of Science:

  • Infectious Diseases
  • Antimicrobial Resistance
  • Pharmacology

Background:

  • Carbapenem-resistant Enterobacteriaceae (CRE) pose a significant global health threat.
  • Effective therapeutic strategies for CRE infections are urgently needed.

Purpose of the Study:

  • To review the latest literature on the therapeutic management of carbapenem-resistant Enterobacteriaceae infections.
  • To evaluate the efficacy of various antibiotic regimens.

Main Methods:

  • Literature review of retrospective and prospective studies published in the last 12 months.
  • Analysis of treatment outcomes for different antibiotic combinations.

Main Results:

  • Combination therapy, including carbapenems with colistin, high-dose tigecycline, or aminoglycosides, showed advantages over monotherapy for CRE with carbapenem MICs ≤ 8 µg/mL.
  • For CRE with higher carbapenem MICs, combinations of colistin, high-dose tigecycline, aminoglycosides, and fosfomycin were associated with reduced mortality.

Conclusions:

  • Limited literature necessitates caution in making definitive recommendations.
  • Combination regimens, particularly those involving carbapenems or multiple agents like colistin, tigecycline, aminoglycosides, and fosfomycin, appear beneficial for managing CRE infections.
  • Further research is needed to establish optimal treatment strategies.