Carbapenems and alternative β-lactams for the treatment of infections due to extended-spectrum β-lactamase-producing Enterobacteriaceae: What impact on intestinal colonisation resistance?

The incidence of infections caused by extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) is globally on the rise owing to the successful spread of these pathogens both in community-based and healthcare-associated ecosystems [1]. This situation has driven a dramatic increase in carbapenem consumption in high-prevalence areas [2,3], which is suspected to contribute to the ongoing pandemic of carbapenemase-producing Enterobacteriaceae (CPE) [4]. Hence, although clinical data are lacking to convincingly support a prominent role of carbapenem exposure on the hazard of CPE acquisition, restraining the consumption of these antimicrobial agents by favouring the use of other β-lactams—either ancient or newly available drugs—is increasingly encouraged by institutional antimicrobial stewardship programmes [5].
Source: International Journal of Antimicrobial Agents - Category: Drugs & Pharmacology Authors: Tags: Review Source Type: research