Abstract
In this editorial, we treat the multi-drug-resistance of microorganisms such as Klebsiella pneumonia (Kp) and Acinetobacter baumanii and the issues concerning the management of these infections. Diseases caused by carbapenemase-resistant Kp (CR-Kp) represent an emerging threat worldwide due to high mortality rate and limited therapeutic options. Consequently innovative therapies have been suggested for their treatment. Colistin- based combinations are considered the milestone of the therapy for CR-Kp. They include meropenem+colistin, meropenem +colistin+tigecycline, the double carbapenem+colistin, tigecycline+colistin, colistin+gentamicin and even colistin +vancomycin. However, colistin use might be limited by its potential nephrotoxicity and resistance. Other antibiotic combinations concern the tigecycline with gentamicin, fosfomycin with aminoglycoside and ertapenem with meropenem. Thus, the double carbapenem-regimen might be considered as a suitable therapy in those subjects in whom previous antimicrobial combinations failed. New antibiotics such as ceftazidime-avibactam effective on CR-Kp and ceftolozane-tazobactam active against XDR (Extensively Drug Resistant) Pseudomonas aeruginosa are now being used in many countries. The mortality results to be lower in patients treated with antibiotic combinations than in those who underwent monotherapy. Efforts should be made by the clinicians in order to limit the widespread of these resistant microorganisms all over the world. Encouraging new solutions as bacteriophage therapy or biocides currently does not seem the right choice.
Highlights
The double carbapenem-regimen might be considered as a suitable therapy in those subjects in whom previous antimicrobial combinations failed
Infections caused by multidrug-resistant (MDR) Gram-negative bacteria such as Acinetobacter baumannii and Klebsiella pneumoniae constitute an important issue for establishing a correct and appropriate therapy in patients suffering from diseases deriving from these microorganisms, both in Intensive Care Units (ICUs) and in non-ICU settings
It has been reported that for infections due to KPC-producing K. pneumoniae, treatment failure was more common among patients who were treated with monotherapy than among those undergone antibiotic combinations [24]
Summary
The double carbapenem-regimen might be considered as a suitable therapy in those subjects in whom previous antimicrobial combinations failed. The in vitro synergistic activity of meropenem plus ertapenem against pandrug-resistant Klebsiella isolated from 14 patients with CP-Kp infections who were successfully treated with a double-carbapenem therapy (ertapenem and meropenem).
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
