Sparing carbapenem usage

Abstract

More agents may need to be introduced onto the antibiotic formulary of the hospital, despite the poor quality of scientific studies in some cases.

Development of the predicted and standardized carbapenem usage metric: Analysis of the Japanese Diagnosis Procedure Combination payment system data

“…Given the continued increase in carbapenem resistance among Gram-negative bacteria across several countries, the use of carbapenems and antibiotics to which resistance is linked should be reduced to slow down its emergence [1]. Antimicrobial stewardship programs (ASPs) have been positioned to address carbapenem resistance by implementing interventions that improve carbapenem use based on carbapenem consumption monitoring [2]. Limiting unnecessary carbapenem use could effectively reduce resistance rates among problematic nosocomial pathogens, such as Pseudomonas aeruginosa [3].…”

Safety of a Carbapenem-Sparing Approach as Part of an Antibiotic Stewardship Program, in a Setting with Increased Carbapenem Resistance

“…Carbapenems have been the recommended therapy for extended-spectrum beta-lactam (ES-BL)-producing Enterobacteriaceae and other multidrug-resistant (MDR) pathogens; however, their over-prescription was the driving force for the endemicity of carbapenem resistance of Gram-negative pathogens in Greece (2)(3)(4). Antimicrobial stewardship programs (ASPs) are interventions to improve and assess the proper use of antimicrobial agents, which requires the selection of the best antimicrobial drug regimen, i.e.…”

“…doses, therapy duration, and administration routes (5)(6)(7). These programs are a useful tool, targeting to improve antibiotic use, spare the carbapenem class of antimicrobials and maybe diminish antibiotic resistance rates of key nosocomial pathogens (4,5,8). Decrease in carbapenem prescription when non-necessary, has become one of the pivotal ASP targets, particularly in areas with carbapenem-resistance endemicity, although optimal treatment of ESBL and CR infections with non-carbapenem containing regimens remains a matter of ongoing debate (4,8,(9)(10)(11).…”

Development of Broth Microdilution MIC and Disk Diffusion Antimicrobial Susceptibility Test Quality Control Ranges for the Combination of Cefepime and the Novel β-Lactamase Inhibitor Enmetazobactam

“…As increased usage of carbapenems to treat ESBL-producing pathogens has helped drive carbapenem resistance, "carbapenem-sparing" therapeutic options are required to stem resistance development and dissemination among Gram-negative pathogens (2,32,33). Development of the combination of cefepime with the novel BLI enmetazobactam aims to provide empiric and definitive therapy for infections caused by Enterobacteriaceae, particularly those expressing ESBLs.…”