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VOLUME 18 , ISSUE 5 ( May, 2014 ) > List of Articles

SHORT COMMUNICATION

Current concepts in combination antibiotic therapy for critically ill patients

Arvind Baronia

Keywords : Carbapenem-resistant enterobacteriaceae, combination antibiotic therapy, Klebsiella pneumoniae carbapenemase, sepsis

Citation Information : Baronia A. Current concepts in combination antibiotic therapy for critically ill patients. Indian J Crit Care Med 2014; 18 (5):310-314.

DOI: 10.4103/0972-5229.132495

License: CC BY-ND 3.0

Published Online: 01-07-2005

Copyright Statement:  Copyright © 2014; The Author(s).


Abstract

Widespread emergence of multidrug resistant (MDR) bacterial pathogens is a problem of global dimension. MDR infections are difficult to treat and frequently associated with high mortality. More than one antibiotic is commonly used to treat such infections, but scientific evidence does not favor use of combination therapy in most cases. However, there are certain subgroups where combination therapy may be beneficial, e.g. sepsis due to carbapenem-resistant Enterobacteriaceae (CRE), bacteremic pneumococcal pneumonia, and patients with multiple organ failure. Well-designed prospective studies are needed to clearly define the role of combination therapy in these subgroups.


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  1. Magiorakos AP, Srinivasan A, Carey RB, Carmeli Y, Falagas ME, Giske CG, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: An international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012;18:268-81.
  2. Gupta N, Limbago BM, Patel JB, Kallen AJ. Carbapenem-resistant Enterobacteriaceae: Epidemiology and prevention. Clin Infect Dis 2011;53:60-7.
  3. Paul M, Benuri-Silbiger I, Soares-Weiser K, Leibovici L. Beta lactam monotherapy versus beta lactam-aminoglycoside combination therapy for sepsis in immunocompetent patients: Systematic review and meta-analysis of randomised trials. BMJ 2004;328:668.
  4. Paul M, Silbiger I, Grozinsky S, Soares-Weiser K, Leibovici L. Beta lactam antibiotic monotherapy versus beta lactam-aminoglycoside antibiotic combination therapy for sepsis. Cochrane Database Syst Rev 2006:CD003344.
  5. Tamma PD, Cosgrove SE, Maragakis LL. Combination therapy for treatment of infections with gram-negative bacteria. Clin Microbiol Rev 2012;25:450-70.
  6. Kumar A, Ellis P, Arabi Y, Roberts D, Light B, Parrillo JE, et al. Cooperative Antimicrobial Therapy of Septic Shock Database Research Group. Initiation of inappropriate antimicrobial therapy results in a fivefold reduction of survival in human septic shock. Chest 2009;136:1237-48.
  7. Micek ST, Lloyd AE, Ritchie DJ, Reichley RM, Fraser VJ, Kollef MH. Pseudomonas aeruginosa bloodstream infection: Importance of appropriate initial antimicrobial treatment. Antimicrob Agents Chemother 2005;49:1306-11.
  8. Kollef MH. Inadequate antimicrobial treatment: An important determinant of outcome for hospitalized patients. Clin Infect Dis 2000;31:S131-8.
  9. Lautenbach E, Patel JB, Bilker WB, Edelstein PH, Fishman NO. Extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiellapneumoniae: Risk factors for infection and impact of resistance on outcomes. Clin Infect Dis 2001;32:1162-71.
  10. Schwaber MJ, Carmeli Y. Mortality and delay in effective therapy associated with extended-spectrum beta-lactamase production in Enterobacteriaceae bacteraemia: A systematic review and meta-analysis. J. Antimicrob Chemother 2007;60:913-20.
  11. Pournaras S, Vrioni G, Neou E, Dendrinos J, Dimitroulia E, Poulou A, et al. Activity of tigecycline alone and in combination with colistin and meropenem against Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacteriaceae strains by time-kill assay. Int J Antimicrob Agents 2011;37:244-7.
  12. Lee J, Patel G, Huprikar S, Calfee DP, Jenkins SG. Decreased susceptibility to polymyxin B during treatment for carbapenem-resistant Klebsiella pneumoniae infection. J Clin Microbiol 2009;47:1611-2.
  13. Chen LF, Anderson DJ, Paterson DL. Overview of the epidemiology and the threat of Klebsiella pneumoniae carbapenemases (KPC) resistance. Infect Drug Resist 2012;5:133-41.
  14. Arnold RS, Thom KA, Sharma S, Phillips M, Kristie Johnson J, Morgan DJ. Emergence of Klebsiella pneumoniae carbapenemase-producing bacteria. South Med J 2011;104:40-5.
  15. Hirsch EB, Tam VH. Detection and treatment options for Klebsiella pneumoniae carbapenemases (KPCs): An emerging cause of multidrug-resistant infection. J Antimicrob Chemother 2010;65:1119-25.
  16. Lee GC, Burgess SD. Treatment of Klebsiella pneumoniae carbapenemase (KPC) infections: A review of published case series and case reports. Ann Clin Microbiol Antimicrob 2012;11:32.
  17. Petrosillo N, Chinello P, Proietti MF, Cecchini L, Masala M, Franchi C, et al. Combined colistin and rifampicin therapy for carbapenem-resistant Acinetobacter baumannii infections: Clinical outcome and adverse events. Clin Microbiol Infect 2005;11:682-3.
  18. Qureshi ZA, Paterson DL, Potoski BA, Kilayko MC, Sandovsky G, Sordillo E, et al. Treatment outcome of bacteremia due to KPC-producing Klebsiella pneumoniae: Superiority of combination antimicrobialregimens. Antimicrob Agents Chemother 2012;56:2108-13.
  19. Tumbarello M, Viale P, Viscoli C, Trecarichi EM, Tumietto F, Marchese A, et al. Predictors of mortality in bloodstream infections caused by Klebsiella pneumoniae carbapenemase-producing K. pneumoniae: Importance of combination therapy. Clin Infect Dis 2012;55:943-50.
  20. Daikos GL, Markogiannakis A. Carbapenemase-producing Klebsiellapneumoniae: (When) might we still consider treating with carbapenems? Clin Microbiol Infect 2011;17:1135-41.
  21. Kumarasamy KK, Toleman MA, Walsh TR, Bagaria J, Butt F, Balakrishnan R, et al. Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: A molecular, biological, and epidemiological study. Lancet Infect Dis 2010;10:597-602.
  22. Durante-Mangoni E, Signoriello G, Andini R, Mattei A, De Cristoforo M, Murino P, et al. Colistin and rifampicin compared with colistin alone for the treatment of serious infections due to extensively drug-resistant Acinetobacter baumannii: A multicenter, randomized clinical trial. Clin Infect Dis 2013;57:349-58.
  23. Petrosillo N, Giannella M, Lewis R, Viale P. Treatment of carbapenem-resistant Klebsiella pneumoniae: The state of the art. Expert Rev Anti Infect Ther 2013;11:159-77.
  24. Lim WS, van der Eerden MM, Laing R, Boersma WG, Karalus N, Town GI, et al. Defining community acquired pneumonia severity on presentation to hospital: An international derivation and validation study. Thorax 2003;58:377-82.
  25. Weiss K, Tillotson GS. The controversy of combination vs monotherapy in the treatment of hospitalized community-acquired pneumonia. Chest 2005;128:940-6.
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