Carbapenem-resistant Enterobacteriaceae: a review of treatment and outcomes |
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| Authors: | David van Duin Keith S. Kaye Elizabeth A. Neuner Robert A. Bonomo |
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| Affiliation: | 1. Department of Infectious Diseases, Cleveland Clinic, Cleveland, OH, USA;2. Transplant Center, Cleveland Clinic, Cleveland, OH, USA;3. Division of Infectious Diseases, Detroit Medical Center, Wayne State University, Detroit, MI, USA;4. Department of Pharmacy, Cleveland Clinic, Cleveland, OH, USA;5. Research Service, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, OH, USA;6. Department of Medicine, Case Western Reserve University School of Medicine, Cleveland OH, USA;g Department of Pharmacology, Case Western Reserve University School of Medicine, Cleveland, OH, USA;h Department of Molecular Biology and Microbiology, Case Western Reserve University School of Medicine, Cleveland, OH, USA;i Medical Service, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, OH, USA |
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| Abstract: | The emergence of carbapenem resistance in Enterobacteriaceae is an important threat to global health. Reported outcomes of infections with carbapenem-resistant Enterobacteriaceae (CRE) are poor. Very few options remain for the treatment of these virulent organisms. Antibiotics which are currently in use to treat CRE infections include aminoglycosides, polymyxins, tigecycline, fosfomycin, and temocillin. In addition, the role of combination therapy, including carbapenem containing regimens, remains to be defined. There are several important concerns regarding all of these treatment options such as limited efficacy, increasing reports of resistance, and specific toxicities. Data from retrospective studies favor combination therapy over single-agent therapy for the treatment of CRE bloodstream infections. In summary, new antibiotics are greatly needed, as is additional prospective research. |
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| Keywords: | Enterobacteriaceae Carbapenem resistance Multidrug resistance Mortality Bacteremia |
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