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[New possibilities in antibacterial treatment of intra-abdominal infections caused by multiresistant microflora]

M D Dibirov1, N N Khachatryan1, A I Isaev1

  • 1Department of Surgery and Clinical Angiology at Moscow State University of Medicine and Dentistry named after A.I. Evdokimov, Moscow, Russia.

Khirurgiia
|December 12, 2019
PubMed
Abstract

Insights

New antibiotics like ceftolozane/tazobactam and ceftazidim/avibactam offer options for treating complicated intra-abdominal infections caused by multidrug-resistant organisms.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Pharmacology

Background:

  • Complicated intra-abdominal infections (cIAIs) pose treatment challenges due to rising antimicrobial resistance.
  • Multidrug-resistant (MDR) pathogens are increasingly implicated in cIAIs.
  • Novel antimicrobial agents are needed to combat MDR infections.

Purpose of the Study:

  • To evaluate the role of new antibiotics against MDR pathogens in cIAIs.
  • To define the potential use of ceftolozane/tazobactam and ceftazidim/avibactam in treating cIAIs.

Main Methods:

  • Analysis of pathogen incidence and distribution in intra-abdominal infections.
  • Review of current antimicrobial resistance trends.
  • Assessment of new drug efficacy against MDR strains.

Main Results:

  • Ceftolozane/tazobactam plus metronidazole shows promise for empiric treatment of cIAIs.
  • Ceftazidim/avibactam plus metronidazole is effective for targeted therapy against carbapenem-resistant Enterobacteriaceae (CRE), including Klebsiella pneumoniae.
  • These agents represent important additions to the therapeutic armamentarium against MDR pathogens in cIAIs.

Conclusions:

  • Ceftolozane/tazobactam with metronidazole can be considered for empiric therapy based on local resistance data.
  • Ceftazidim/avibactam with metronidazole is recommended for targeted therapy of CRE infections due to its high activity and lack of alternatives.
Keywords:
EnterobacterialesPseudomonas aeruginosacarbapenemsceftazidim/avibactamceftolozane/tazobactamintra-abdominal infectionsmicrobial resistancemultidrug resistant strains

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