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Open AccessReview

Carbapenem-Sparing Strategies for ESBL Producers: When and How

Department of Internal Medicine-Infectious Diseases, Hygeia General Hospital, 15123 Athens, Greece
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Received: 29 December 2019 / Revised: 27 January 2020 / Accepted: 3 February 2020 / Published: 5 February 2020
Extended spectrum β-lactamase (ESBL)-producing bacteria are prevalent worldwide and correlated with hospital infections, but they have been evolving as an increasing cause of community acquired infections. The spread of ESBL constitutes a major threat for public health, and infections with ESBL-producing organisms have been associated with poor outcomes. Established therapeutic options for severe infections caused by ESBL-producing organisms are considered the carbapenems. However, under the pressure of carbapenem overuse and the emergence of resistance, carbapenem-sparing strategies have been implemented. The administration of carbapenem-sparing antibiotics for the treatment of ESBL infections has yielded conflicting results. Herein, the current available knowledge regarding carbapenem-sparing strategies for ESBL producers is reviewed, and the optimal conditions for the “when and how” of carbapenem-sparing agents is discussed. An important point of the review focuses on piperacillin–tazobactam as the agent arousing the most debate. The most available data regarding non-carbapenem β-lactams (i.e., ceftolozane–tazobactam, ceftazidime–avibactam, temocillin, cephamycins and cefepime) are also thoroughly presented as well as non β-lactams (i.e., aminoglycosides, quinolones, tigecycline, eravacycline and fosfomycin). View Full-Text
Keywords: ESBLs; piperacillin–tazobactam; carbapenem-sparing treatment; cefepime; fosfomycin; urinary tract infection ESBLs; piperacillin–tazobactam; carbapenem-sparing treatment; cefepime; fosfomycin; urinary tract infection
MDPI and ACS Style

Karaiskos, I.; Giamarellou, H. Carbapenem-Sparing Strategies for ESBL Producers: When and How. Antibiotics 2020, 9, 61. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics9020061

AMA Style

Karaiskos I, Giamarellou H. Carbapenem-Sparing Strategies for ESBL Producers: When and How. Antibiotics. 2020; 9(2):61. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics9020061

Chicago/Turabian Style

Karaiskos, Ilias; Giamarellou, Helen. 2020. "Carbapenem-Sparing Strategies for ESBL Producers: When and How" Antibiotics 9, no. 2: 61. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics9020061

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Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

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