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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Pediatr+Pharmacol+Ther
2016 ; 21
(2
): 110-9
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Beyond Susceptible and Resistant, Part III: Treatment of Infections due to
Gram-Negative Organisms Producing Carbapenemases
#MMPMID27199618
Narayanan N
; Johnson L
; MacDougall C
J Pediatr Pharmacol Ther
2016[Mar]; 21
(2
): 110-9
PMID27199618
show ga
Carbapenemases are enzymes that are capable of inactivating all or almost all
beta-lactam antimicrobial agents. These enzymes are frequently coexpressed with
other resistance mechanisms to non-beta-lactams, leading to extremely
drug-resistant pathogens. Once a curiosity, these enzymes have spread into
organisms that are among the most common causes of infection, such as Klebsiella
pneumoniae and Escherichia coli. Identification of these organisms has proved
challenging for clinical microbiology laboratories, leading to revisions in
susceptibility standards for carbapenems. Although currently a rare cause of
infection in children, these carbapenem-resistant Enterobacteriaceae (CRE) are
becoming endemic in a variety of healthcare settings. Management of infections
due to CRE is complicated by a lack of effective treatment options and clinical
data on their effectiveness. Treatment of CRE infections in children is
particularly challenging because therapeutic options for CRE lack adequate data
on dosing and safety in children. Use of unconventional combination treatment
regimens, including agents to which the organism is resistant in vitro, may
provide some benefit in the treatment of severe CRE infection. Fortunately,
several agents with the potential for treatment of CRE infections have been
recently approved or are in late clinical development, although few data will be
available in the short term to inform use in children.