Carbapenems and alternative beta-lactams for the treatment of infections due to ESBL-producing Enterobacteriaceae: what impact on intestinal colonization resistance?

The incidence of infections due to extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBLE) is globally on the rise owing to the successful spread of these pathogens in both community-based and healthcare-associated ecosystems [1]. This situation drives a dramatic increase in carbapenem consumption in high prevalence areas [2, 3], which is suspected to contribute to the on-going pandemic of carbapenemase-producing Enterobacteriaceae (CPE) [4]. Hence, and 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 favoring the use of other beta-lactams – either ancient or newly available drugs – is increasingly encouraged by institutional antibiotic stewardship programs [5].
Source: International Journal of Antimicrobial Agents - Category: Drugs & Pharmacology Authors: Tags: Review Source Type: research