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http://www.utexas.edu/pharmacy/divis...ee02-17-12.pdf
Epidemiology and treatment of KPC?S?What?s the news?
Review of Current Evidence
Grace C. Lee, Pharm.D, BCPS
Pharmacotherapy Rounds 2012
2/17/2012
Key Points:
1. KPCs are rapidly spreading globally
2/ Detection has been difficult since many KPC-producing isolates fall within the susceptible range
3. Infections caused by KPC-producing bacteria have been associated with high mortality and treatment failure
4. Tigecycline and polymyxins remain the most active in-vitro
5. Clinical data on treatment is limited and therapy for KPC infections is not well defined
6. Combination therapy may be associated with less failure than monotherapy
7. No data on which combination therapy is superior
Current Situation Carbapenems are broad spectrum antibiotics that are often used as last-resort treatments for resistant gram-negative infections, such as those caused by extended spectrum β-lactamase (ESBL) producing Enterobacteriaceae. The rise of carbapenem-resistant Enterobacteriaceae (CRE) has become a significant public health challenge in the last decade.1 Data regarding health-care-associated infections reported to the Centers for Disease Control and Prevention (CDC) indicated that 8% of all Klebsiella pneumoniae isolates were carbapenem resistant in 2007 compared with less than 1% in 2000. CREs are highly-resistant to almost, if not, all available antimicrobial agents and present clinicians with serious treatment challenges.
Review of Current Evidence
Grace C. Lee, Pharm.D, BCPS
Pharmacotherapy Rounds 2012
2/17/2012
Key Points:
1. KPCs are rapidly spreading globally
2/ Detection has been difficult since many KPC-producing isolates fall within the susceptible range
3. Infections caused by KPC-producing bacteria have been associated with high mortality and treatment failure
4. Tigecycline and polymyxins remain the most active in-vitro
5. Clinical data on treatment is limited and therapy for KPC infections is not well defined
6. Combination therapy may be associated with less failure than monotherapy
7. No data on which combination therapy is superior
Current Situation Carbapenems are broad spectrum antibiotics that are often used as last-resort treatments for resistant gram-negative infections, such as those caused by extended spectrum β-lactamase (ESBL) producing Enterobacteriaceae. The rise of carbapenem-resistant Enterobacteriaceae (CRE) has become a significant public health challenge in the last decade.1 Data regarding health-care-associated infections reported to the Centers for Disease Control and Prevention (CDC) indicated that 8% of all Klebsiella pneumoniae isolates were carbapenem resistant in 2007 compared with less than 1% in 2000. CREs are highly-resistant to almost, if not, all available antimicrobial agents and present clinicians with serious treatment challenges.