Video Experimental Relacionado

Updated: Sep 9, 2025

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

Published on: August 30, 2018

Manejo de las infecciones graves MDR/XDR en pacientes críticos

Luca Mezzadri^1,2, Ya-Ting Chang^1,3, David L Paterson^1,4

¹ADVANCE-ID, Saw Swee Hock School of Public Health, National University of Singapore, Singapore.

Current opinion in critical care

|September 5, 2025

Resumen

La gestión de infecciones graves por patógenos multirresistentes (MDR) y extensamente resistentes (XDR) requiere un conocimiento actualizado de los tratamientos y la resistencia. Los ensayos clínicos de alta calidad son cruciales para la terapia basada en la evidencia contra estas infecciones difíciles.

Área de la Ciencia:

Enfermedades infecciosas
Microbiología clínica
Farmacología

Sus antecedentes:

Las infecciones graves causadas por patógenos multirresistentes (MDR) y extensamente resistentes a los medicamentos (XDR) representan un desafío significativo para la salud mundial.
Las directrices actuales de tratamiento a menudo están limitadas por la falta de datos sólidos de ensayos clínicos para estos organismos difíciles de tratar.

Objetivo del estudio:

Revisar las recomendaciones actuales para el tratamiento de infecciones graves causadas por patógenos MDR/XDR.
Centrarse en la evidencia de los ensayos controlados aleatorios (ECA) y resaltar las opciones terapéuticas emergentes.

Principales métodos:

Revisión sistemática de ensayos controlados aleatorios (ECA) y datos clínicos recientes.
Análisis de las estrategias de tratamiento para patógenos MDR/XDR específicos, incluidas las bacterias Gram-positivas y Gram-negativas.

Principales resultados:

Para las infecciones del torrente sanguíneo por Staphylococcus aureus (MRSA) resistentes a la meticilina, la vancomicina, el linezolid y la daptomicina son las opciones primarias, con ceftobiprol como agente más reciente.
El tratamiento de las IBS de Enterococcus faecium resistentes a la vancomicina se basa en linezolida y daptomicina.
El tratamiento de las infecciones Gram negativas MDR / XDR es un desafío; las nuevas combinaciones de inhibidores de la beta-lactama / beta-lactamases son clave para los Enterobacterales y Pseudomonas aeruginosa resistentes al carbapenem.
Cefiderocol y ceftazidima-avibactam más aztreonam son las opciones de último recurso para los productores de metallo-β-lactamasas.
El sulbactam-durlobactam es prometedor para el Acinetobacter baumannii resistente al carbapenem, pero su disponibilidad es limitada.

Conclusiones:

La gestión eficaz de las infecciones graves MDR/XDR requiere actualizaciones continuas sobre las opciones de tratamiento y los patrones de resistencia.
Hay una necesidad crítica de más ensayos clínicos de alta calidad para establecer pautas terapéuticas basadas en la evidencia.

Palabras clave:

Resistencia a los antimicrobianos Infección del torrente sanguíneo Resistencia a múltiples fármacos Pneumonia asociada con el ventilador

Más Videos Relacionados

Antimicrobial Synergy Testing by the Inkjet Printer-assisted Automated Checkerboard Array and the Manual Time-kill Method

Antimicrobial Synergy Testing by the Inkjet Printer-assisted Automated Checkerboard Array and the Manual Time-kill Method

Published on: April 18, 2019

Growing a Cystic Fibrosis-Relevant Polymicrobial Biofilm to Probe Community Phenotypes

Growing a Cystic Fibrosis-Relevant Polymicrobial Biofilm to Probe Community Phenotypes

Published on: April 19, 2024

Videos de Conceptos Relacionados

Pneumonia IV: Management

Pneumonia IV: Management

The treatment of pneumonia varies based on its severity and the causative pathogen. Here is a structured approach to managing pneumonia, integrating pharmaceutical and supportive care strategies.
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:

Acute Pyelonephritis II: Diagnostic Studies and Management

Acute Pyelonephritis II: Diagnostic Studies and Management

Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...

Pulmonary Tuberculosis V

Pulmonary Tuberculosis V

Medical management of tuberculosis (TB) patients involves a comprehensive approach that includes diagnosis, treatment, and monitoring. The specific strategies can vary depending on the type of tuberculosis (latent or active), the patient's overall health status, and other considerations.
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the...

Acute Respiratory Failure-V

Acute Respiratory Failure-V

The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...

Pneumonia V: Nursing management and Prevention

Pneumonia V: Nursing management and Prevention

Nursing management of pneumonia involves promoting airway patency, facilitating rest and conserving energy, encouraging fluid intake, maintaining nutrition, and educating patients.
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....

Transmission-based Precautions II: Airborne and Protective Environment

Transmission-based Precautions II: Airborne and Protective Environment

Transmission-based precautions are for patients infected or suspected to be infected (or colonized) with organisms posing a significant risk to others. The transmission precautions include airborne and protective environment precautions.
Airborne precautions:
Use airborne precautions when treating patients known or suspected to have diseases that spread through the air—for example, tuberculosis or measles. These organisms are present in smaller droplets expelled by an infected person and...