Combination Therapy for Treatment of Infections with Gram-Negative Bacteria
Clin. Microbiol. Rev. July 2012 25(3): 450-470
Pranita D. Tamma, Sara E. Cosgrove, and Lisa L. Maragakis
aThe Johns Hopkins Medical Institutions, Department of Medicine, Division of Pediatric Infectious Diseases, Baltimore, Maryland, USA
bThe Johns Hopkins Medical Institutions, Department of Medicine, Division of Infectious Diseases, Baltimore, Maryland, USA
Combination antibiotic therapy for invasive infections with Gram-negative bacteria is employed in many health care facilities, especially for certain subgroups of patients, including those with neutropenia, those with infections caused by Pseudomonas aeruginosa, those with ventilator-associated pneumonia, and the severely ill. An argument can be made for empiric combination therapy, as we are witnessing a rise in infections caused by multidrug-resistant Gram-negative organisms. The wisdom of continued combination therapy after an organism is isolated and antimicrobial susceptibility data are known, however, is more controversial. The available evidence suggests that the greatest benefit of combination antibiotic therapy stems from the increased likelihood of choosing an effective agent during empiric therapy, rather than exploitation of in vitro synergy or the prevention of resistance during definitive treatment. In this review, we summarize the available data comparing monotherapy versus combination antimicrobial therapy for the treatment of infections with Gram-negative bacteria.
Entry filed under: Antimicrobianos, Bacterias, Bacteriemias, Epidemiología, Health Care-Associated Infections, HIC no SIDA, Infecciones asociadas a catater IV, Infecciones en diabeticos, Infecciones en neutropenicos, Infecciones en onco-hematologicos, Infecciones nosocomiales, Infecciones respiratorias, Metodos diagnosticos, Resistencia bacteriana, REVIEWS, Sepsis, Update.