Polymyxins: Antimicrobial susceptibility concerns and therapeutic options.
Indian J Med Microbiol
;
2011 Jul-Sept; 29(3): 230-242
Artículo
en Inglés
| IMSEAR
| ID: sea-143823
ABSTRACT
The increasing prevalence of multidrug-resistant nosocomial pathogens such as Acinetobacter baumannii, Pseudomonas aeruginosa and Klebsiella pneumoniae poses a great challenge to the treating physicians. The paucity of newer effective antimicrobials has led to renewed interest in the polymyxin group of drugs, as a last resort for treatment of gram-negative bacterial infections. There is a dearth of information on the pharmacological properties of colistin, leading to difficulties in selecting the right dose, dosing interval, and route of administration for treatment, especially in critically-ill patients. The increasing use of colistin over the last few years necessitates the need for accurate and reliable in vitro susceptibility testing methods. Development of heteroresistant strains as a result of colistin monotherapy is also a growing concern. There is a compelling need from the clinicians to provide options for probable and possible colistin combination therapy for multidrug-resistant bacterial infections in the ICU setting. Newer combination drug synergy determination tests are being developed and reported. There are no standardized recommendations from antimicrobial susceptibility testing reference agencies for the testing and interpretation of these drug combinations. Comparison and analysis of these reported methodologies may help to understand and assist the microbiologist to choose the best method that produces accurate results at the earliest. This will help clinicians to select the appropriate combination therapy. In this era of multidrug resistance it is important for the microbiology laboratory to be prepared, by default, to provide timely synergistic susceptibility results in addition to routine susceptibility, if warranted. Not as a favour or at request, but as a responsibility.
Texto completo:
Disponible
Índice:
IMSEAR (Asia Sudoriental)
Asunto principal:
Pseudomonas aeruginosa
/
Humanos
/
Pruebas de Sensibilidad Microbiana
/
Infecciones por Bacterias Gramnegativas
/
Polimixinas
/
Farmacorresistencia Bacteriana
/
Acinetobacter baumannii
/
Klebsiella pneumoniae
/
Antibacterianos
Tipo de estudio:
Guía de Práctica Clínica
Idioma:
Inglés
Revista:
Indian J Med Microbiol
Asunto de la revista:
Microbiology
Año:
2011
Tipo del documento:
Artículo
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