Раннее назначение цефтазидима-авибактама как путь к повышению эффективности антибактериальной терапии инфекций, вызванных карбапенемрезистентными возбудителями

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Обзор литературы посвящен проблеме растущей устойчивости к антибактериальным препаратам ведущих возбудителей нозокомиальных инфекций. Проанализированы современные данные о распространенности и механизмах резистентности микроорганизмов в Российской Федерации. Особое внимание уделено штаммам, устойчивым к карбапенемам. Дана характеристика препаратов, применяемых для терапии инфекций, вызванных карбапенемрезистентными возбудителями. Приведен анализ сообщений о клиническом применении препарата цефтазидим+[авибактам], демонстрирующий преимущество этого антибиотика по сравнению с традиционными схемами терапии, включающими полимиксины, тигециклин, аминогликозиды и другие препараты. Отмечена высокая эффективность монотерапии препаратом цефтазидим+[авибактам] инфекций, вызванных энтеробактериями — продуцентами сериновых карбапенемаз. Подчеркнута важность раннего назначения препарата цефтазидим+[авибактам] для реализации максимального терапевтического потенциала. Предложен комплекс мер по оптимизации использования этого препарата, в их числе внедрение современных методов микробиологической диагностики, определение чувствительности возбудителей к ингибиторзащищенным цефалоспоринам, расшифровка механизмов устойчивости, включение в схемы эмпирической терапии у пациентов с факторами риска карбапенемрезистентности.

Ключевые слова:

карбапенемрезистентные энтеробактерии

цефтазидим-авибактам

клиническая эффективность

Авторы:

Белоцерковский Б.З.

1. ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России;
2. ГБУЗ города Москвы «Московский многопрофильный клинический центр «Коммунарка» Департамента здравоохранения города Москвы»

ORCID: 0000-0002-5758-5703

Костин Д.М.

ГБУЗ города Москвы «Московский многопрофильный клинический центр «Коммунарка» Департамента здравоохранения города Москвы»

ORCID: 0000-0003-0426-6837

Быков А.О.

ORCID: 0000-0001-5244-7769

Матяш М.И.

ORCID: 0009-0004-0764-4658

Шифман Е.М.

ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России

ORCID: 0000-0002-6113-8498

Проценко Д.Н.

ORCID: 0000-0002-5166-3280

Дата поступления:

29.01.2024

Дата принятия в печать:

22.02.2024

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