Expert review of anti-infective therapy
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Expert Rev Anti Infect Ther · Sep 2010
ReviewMultidrug-resistant Gram-negative infections: the use of colistin.
The emergence of nosocomial infections due to multidrug-resistant Gram-negative bacteria led to the revival of 'forgotten' antibiotics, such as polymyxins. Colistin, mainly colistimethate sodium (polymyxin E), has been predominantly used. ⋯ Although colistin is commonly administered intravenously, it can also be administered via inhalation for pneumonia/ventilator-associated pneumonia treatment or by the intraventricular/intrathecal route for meningitis/ventriculitis treatment. Randomized controlled trials are needed to answer clinical questions such as the appropriate colistin dose, to compare colistin monotherapy with combination therapy, and to determine the exact therapeutic role of aerosolized or intrathecal/intraventricular administration of colistin.
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Expert Rev Anti Infect Ther · Sep 2010
ReviewResistant pathogen-associated skin and skin-structure infections: antibiotic options.
Complicated skin and skin-structure infections (cSSSIs) are among the most common infections treated in the hospital setting. They are a significant clinical problem, partially owing to increasing resistance of infecting bacteria to current antibiotic therapies (nosocomial and community-acquired methicillin-resistant Staphylococcus aureus, extended spectrum beta-lactamase-producing-Enterobacteriaceae, and multidrug-resistant [MDR] Pseudomonas aeruginosa, among others). ⋯ In this context, the use of new antibiotic agents (i.e., linezolid, daptomycin and tigecycline) and the optimization of the pharmacodynamic targets of classic antibiotics (i.e., carbapenems) is one potential solution to these problems, and some of these agents are highlighted in this article. The purpose of this article is to provide clinicians with an evidence-based review of MDR pathogens causing cSSSIs, the implications of resistance to currently used drug therapy, and to identify new therapeutic options for resistant pathogens causing cSSSIs.