Best practices: Appropriate use of the new β-lactam/β-lactamase inhibitor combinations, ceftazidime-avibactam and ceftolozane-tazobactam in South Africa.

Autor:	Brink AJ; Division of Medical Microbiology, Institute of Infectious Diseases and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa., Coetzee J; Division of Microbiology, Ampath National Reference Laboratory, Centurion, South Africa., Richards GA; Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa., Feldman C; Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa., Lowman W; Department of Clinical Microbiology, Pathcare/Vermaak Pathologists, Gauteng, South Africa, South Africa.; Department Clinical Microbiology and Infectious Diseases, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.; Department of Clinical Microbiology and Infection Prevention and Control, Wits Donald Gordon Medical Centre, Johannesburg, South Africa., Tootla HD; Division of Medical Microbiology, National Health Laboratory Service, Red Cross War Memorial Children's Hospital, Cape Town, South Africa., Miller MGA; Division of Critical Care, Department of Anaesthesia and Perioperative Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa., Niehaus AJ; Department of Medical Microbiology, Ampath Laboratory Services, Cape Town, South Africa., Wasserman S; Division of Infectious Diseases and HIV Medicine, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.; Wellcome Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa., Perovic O; National Institute for Communicable Disease, National Health Laboratory Services, Johannesburg, South Africa.; School of Pathology, Clinical Microbiology and Infectious Diseases, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa., Govind CN; Department of Medical Microbiology, Lancet Laboratories, KwaZulu-Natal, Durban, South Africa.; Antimicrobial Research Unit, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa., Schellack N; Department of Pharmacology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa., Mendelson M; Division of Infectious Diseases and HIV Medicine, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.
Jazyk:	angličtina
Zdroj:	Southern African journal of infectious diseases [S Afr J Infect Dis] 2022 Oct 20; Vol. 37 (1), pp. 453. Date of Electronic Publication: 2022 Oct 20 (Print Publication: 2022).
DOI:	10.4102/sajid.v37i1.453
Abstrakt:	Antibiotic stewardship of hospital-acquired infections because of difficult-to-treat resistant (DTR) Gram-negative bacteria is a global challenge. Their increasing prevalence in South Africa has required a shift in prescribing in recent years towards colistin, an antibiotic of last resort. High toxicity levels and developing resistance to colistin are narrowing treatment options further. Recently, two new β-lactam/β-lactamase inhibitor combinations, ceftazidime-avibactam and ceftolozane-tazobactam were registered in South Africa, bringing hope of new options for management of these life-threatening infections. However, with increased use in the private sector, increasing levels of resistance to ceftazidime-avibactam are already being witnessed, putting their long-term viability as treatment options of last resort, in jeopardy. This review focuses on how these two vital new antibiotics should be stewarded within a framework that recognises the resistance mechanisms currently predominant in South Africa's multi-drug and DTR Gram-negative bacteria. Moreover, the withholding of their use for resistant infections that can be treated with currently available antibiotics is a critical part of stewardship, if these antibiotics are to be conserved in the long term. Competing Interests: The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article. (© 2022. The Authors.)
Databáze:	MEDLINE
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