马上注册登录，享用更多感控资源，助你轻松入门。
您需要 登录 才可以下载或查看，没有账号？注册
|
×
非常遗憾，我现在还是无法上传附件，否则可以分享全文给大家。
看到2014年新出来的一篇CRE综述，讲的是目前CRE感染治疗的EVIDENCE，总结的挺好。
只能在这里贴出ABSTRACT。
Antibiotic Treatment of Infections Due to Carbapenem-Resistant Enterobacteriaceae: Systematic Evaluation of the Available Evidence
Matthew E. Falagas,a,b,c Panagiota Lourida,a Panagiotis Poulikakos,a,b Petros I. Rafailidis,a Giannoula S. Tansarlia
Alfa Institute of Biomedical Sciences (AIBS), Marousi, Athens, Greecea; Department of Internal Medicine, Infectious Diseases, Mitera Hospital, Hygeia Group, Athens,
Greeceb; Tufts University School of Medicine, Boston, Massachusetts, USAc
We sought to evaluate the effectiveness of the antibiotic treatment administered for infections caused by carbapenemase-producing
Enterobacteriaceae. The PubMed and Scopus databases were systematically searched. Articles reporting the clinical outcomes
of patients infected with carbapenemase-producing Enterobacteriaceae according to the antibiotic treatment administered
were eligible. Twenty nonrandomized studies comprising 692 patients who received definitive treatment were included.
Almost all studies reported on Klebsiella spp. In 8 studies, the majority of infections were bacteremia, while pneumonia and urinary
tract infections were the most common infections in 12 studies. In 10 studies, the majority of patients were critically ill.
There are methodological issues, including clinical heterogeneity, that preclude the synthesis of the available evidence using statistical
analyses, including meta-analysis. From the descriptive point of view, among patients who received combination treatment,
mortality was up to 50% for the tigecycline-gentamicin combination, up to 64% for tigecycline-colistin, and up to 67% for
carbapenem-colistin. Among the monotherapy-treated patients, mortality was up to 57% for colistin and up to 80% for tigecycline.
Certain regimens were administered to a small number of patients in certain studies. Three studies reporting on 194 critically
ill patients with bacteremia showed individually significantly lower mortality in the combination arm than in the monotherapy
arm. In the other studies, no significant difference in mortality was recorded between the compared groups.
Combination antibiotic treatment may be considered the optimal option for severely ill patients with severe infections. However,
well-designed randomized studies of specific patient populations are needed to further clarify this issue.
|
发表于 2014-9-27 17:35
发表于 2014-9-27 22:05
发表于 2020-5-20 14:53