Ureidopenicillins, aztreonam, and thienamycin: efficacy as single-drug therapy of severe infections and potential as components of combined therapy.
Ureidopenicillins, aztreonam, and thienamycin: efficacy as single-drug therapy of severe infections and potential as components of combined therapy.
复制标题
脲青霉素、氨曲南和硫霉素：作为严重感染的单一药物治疗的功效和作为联合治疗的组成部分的潜力。
DOI：
10.1093/jac/17.suppl_a.55
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发表时间：
1986
期刊：
影响因子：
--
通讯作者：
Busuttil,RW
中科院分区：
文献类型：
--
作者：
Winston,DJ;Ho,WG;Champlin,RE;Gale,RP;Busuttil,RW
脲基青霉素（哌拉西林、美洛西林和阿洛西林）、氨曲南和硫霉素是新的广谱β-内酰胺类药物，其抗菌活性比旧的头孢菌素和青霉素更强。然而，单独使用脲基青霉素治疗严重感染受到出现耐药微生物的可能性的限制，而氨曲南单药治疗不能充分覆盖革兰氏阳性需氧微生物和厌氧菌。在与氨基糖苷类联合治疗中，脲基青霉素类在治疗铜绿假单胞菌感染和耐羧苄青霉素或替卡西林微生物流行率高的机构中可能优于羧苄青霉素或替卡西林。哌拉西林+拉氧头孢（氧内酰胺）或头孢他啶的双重β-内酰胺治疗可能对氨基糖苷类毒性值得关注的患者有利。硫霉素是最有希望用于严重感染的单药治疗的新型β-内酰胺类药物，但也可能与耐药P的出现有关。单药治疗的空气动力学。在发热性粒细胞减少症患者或其他有严重风险的重症患者中。对于呼吸道感染，硫霉素或另一种抗假单胞菌β-内酰胺应与氨基糖苷类药物联合使用。
The ureidopenicillins (piperacillin, mezlocillin, and azlocillin), aztreonam, and thienamycin are new broad-spectrumβ-lactams with more potent antibacterial activity than the older cephalosporins and penicillins. However, therapy of severe infections with the ureidopenicillins alone is limited by the potential for emergence of resistant organisms, while monotherapy with aztreonam does not provide adequate coverage for Gram-positive aerobic organisms and anaerobes. In combination therapy with the aminoglycosides, the ureidopenicillins may be preferred to carbenicillin or ticarcillin in the treatment ofPseudomonas aeruginosainfections and in institutions with a high prevalence of carbenicillin or ticarcillin-resistant organisms. Doubleβ-lactam therapy with piperacillin plus either latamoxef (moxalactam) or ceftazidime may be advantageous in patients for whom aminoglycoside toxicity is a concern. Thienamycin is the most promising of the newβ-lactams for single-agent therapy of severe infections but may also be associated with the emergence of resistantP. aeruginosaduring monotherapy. In febrile granulocytopenic patients or other severely ill patients at risk of severeP. aeruginosainfections, thienamycin or another antipseudomonalβ-lactam should be combined with an aminoglycoside.