СОВРЕМЕННАЯ АНТИБАКТЕРИАЛЬНАЯ ТЕРАПИЯ НОЗОКОМИАЛЬНОЙ ПНЕВМОНИИ

В. Б. Белобородов; В. А. Синикин

doi:10.21518/2079-701X-2017-18-70-76

СОВРЕМЕННАЯ АНТИБАКТЕРИАЛЬНАЯ ТЕРАПИЯ НОЗОКОМИАЛЬНОЙ ПНЕВМОНИИ

В. Б. Белобородов, В. А. Синикин

https://doi.org/10.21518/2079-701X-2017-18-70-76

Полный текст:

PDF (Rus)

Аннотация

Нозокомиальная пневмония терминологически объединяет все виды пневмонии, которые возникают у госпитализированных пациентов: пневмонию у пациентов вне искусственной вентиляции легких (госпитальная пневмония, пневмония, связанная с оказанием медицинской помощи) и нозокомиальную пневмонию, связанную с проведением ИВЛ (НПивл), или вентилятор-ассоциированную пневмонию (ВАП). Существенным отличием нозокомиальной пневмонии от внебольничной является разнообразная этиологическая структура, что существенно усложняет выбор антибактериальных препаратов, на этапе эмпирической терапии возникает необходимость применения антибиотиков, активных в отношении внебольничной и нозокомиальной флоры. Роль карбапенемов, в частности дорипенема, в лечении нозокомиальной пневмонии является ведущей в связи с его высокой активностью в отношении резистентной флоры.

Ключевые слова

нозокомиальная пневмония, госпитальная флора, карбапенемы, дорипенем

Об авторах

В. Б. Белобородов

Российская медицинская академия непрерывного профессионального образования Минздрава России
Россия

д.м.н., профессор

В. А. Синикин

Российская медицинская академия непрерывного профессионального образования Минздрава России
Россия

Список литературы

1. Vincent JL, Rello J, Marshall J et al. International study of the prevalence and outcomes of infection in intensive care units. JAMA, 2009, 2, 302(21): 2323-9.

2. Kaniga K, Flamm R, Tong SY et al. Worldwide experience with the use of doripenem against extended-spectrum-beta-lactamase-producing and ciprofloxacin-resistant Enterobacteriacea: analysis of six phase 3 clinical studies. Anti-microb Agents Chemother, 2010, 54: 2119–24.

3. Chao C, Chen C, Huang H et al. Clinical Experience of Patients Receiving Doripenem-Containing Regimens for the Treatment of Healthcare-Associated Infections. PLoS ONE, 2016, 11(12): 1-11.

4. Qu XY, Hu TT, Zhou W. A meta-analysis of efficacy and safety of doripenem for treating bacterial infections. Braz J Infect Dis, 2015, 19: 156–162.

5. Walsh F. Doripenem: a new carbapenem antibiotic a review of comparative antimicrobial and bactericidal activities. Ther Clin Risk Manag, 2007, 3: 789–94.

6. Mendes RE, Rhomberg PR, Bell JM, Turnidge JD, Sader HS. Doripenem activity tested against a global collection of Enterobacteriaceae, including isolates resistant to other extended-spectrum agents. Diagn Microbiol Infect Dis, 2009, 63: 415–25.

7. Horiuchi M, Kimura M, Tokumura M, Hasebe N, Arai T, Abe K. Absence of convulsive liability of doripenem, a new carbapenem antibiotic, in comparison with beta-lactam antibiotics. Toxicology, 2006, 222: 114–24.

8. Kollef MH, Chastre J, Clavel M et al. A rand-omized trial of 7- day doripenem versus 10-day imipenem-cilastatin for ventilator-associated pneumonia. Crit Care, 2012, 16: R218.

9. US Food and Drug Administration. FDA Statement on recently terminated clinical trial with Doribax (doripenem). January 5, 2012. http: //www.fda.gov/ Drugs/DrugSafety/ucm285883.htm.

10. Chastre J, Wunderink R, Prokocimer P et al. Efficacy and safety of intravenous infusion of doripenem versus imipenem in ventilator-associated pneumonia: a multicenter, randomized study. Crit Care Med, 2008, 36: 1089–1096.

11. Saito A W A, Nakata K, Nakata K et al. Comparative study of doripenem and meropenem in respiratory infections. Phase III double-blind comparative study. Jpn J Chemother, 2005, 53(Suppl. 1): 185–204.

12. Rea-Neto A, Niederman M, Lobo SM et al. Efficacy and safety of doripenem versus piper-acillin/tazobactam in nosocomial pneumonia: a randomized, open-label, multicenter study. Curr Med Res Opin, 2008, 24: 2113–2126.

13. Chastre J, Wolff M, Fagon JY et al. Comparison of 8 vs 15 days of antibiotic therapy for ventilator-associated pneumonia in adults: a rand-omized trial. JAMA, 2003, 290(19): 2588-98.

14. Luyt C, Aubry A, Lu Q et al. Imipenem, Meropenem, or Doripenem To Treat Patients with Pseudomonas aeruginosa Ventilator-Associated Pneumonia. Antimicrob Agents Chemother, 2014, 58(3): 1372–1380.

15. Nordmann P, Picazo JJ, Mutters R et al. Comparative activity of carbapenem testing: the COMPACT study. J. Antimicrob. Chemother., 2011, 66: 1070–1078.

16. Lautenbach E, Synnestvedt M, Weiner MG et al. Imipenem resistance in Pseudomonas aeruginosa: emergence, epidemiology, and impact on clinical and economic outcomes. Infect. Control Hosp. Epidemiol., 2010, 31: 47–53.

17. Giantsou E, Manolas K. Superinfections in Pseudo-monas aeruginosa ventilator-associated pneumonia. Minerva Anestesiol, 2011, 77: 964–970.

18. Francois B, Luyt CE, Dugard A et al. Safety and pharmacokinetics of an anti-PcrV PEGylated monoclonal antibody fragment in mechanically ventilated patients colonized with Pseudomonas aeruginosa: a randomized, double- blind, placebo-controlled trial. Crit. Care Med., 2012, 40: 2320–2326.

19. Combes A, Figliolini C, Trouillet JL et al. Factors predicting ventilator-associated pneumonia recurrence. Crit. Care Med., 2003, 31: 1102–1107.

20. Heyland DK, Dodek P, Muscedere J et al. Randomized trial of combination versus mono-therapy for the empiric treatment of suspected ventilator-associated pneumonia. Crit. Care Med., 2008, 36: 737–744.

21. Brunkhorst FM, Oppert M, Marx G et al. Effect of empirical treatment with moxifloxacin and meropenem vs meropenem on sepsis-related organ dysfunction in patients with severe sepsis: a randomized trial. JAMA, 2012, 307: 2390–2399.

22. Planquette B, Timsit JF, Misset B et al. Pseudo-monas aeruginosa ventilator-associated pneumonia: predictive factors of treatment failure. Am. J. Respir. Crit. Care Med., 2013, 188: 69–76.

23. Vossen MG, Wenisch JM, Maier-Salamon A et al. Doripenem Treatment during Continuous Renal Replacement Therapy. Antimicrobial Agents and Chemotherapy, 2016, 60(3): 1687-1694.

24. Thalhammer F, Schenk P, Burgmann H et al. Single-dose pharmacokinetics of meropenem during continuous venovenous hemofiltration. Antimicrob Agents Chemother, 1998, 42: 2417–2420.

25. European Committee on Antimicrobial Susceptibility Testing. 2014. Breakpoint tables for interpretation of MICs and zone diameters, version 4.0. http: //www.eucast.org/fileadmin/ src/media/PDFs/EUCAST_files /Breakpoint_ tables/Breakpoint_table_v_4.0.pdf.

26. Afshartous D, Bauer SR, Connor MJ et al. Pharmacokinetics and pharmacodynamics of imipenem and meropenem in critically ill patients treated with continuous venovenous hemodialy-sis. Am J Kidney Dis, 2014, 63: 170–171.

27. Taccone FS, Laterre P-F, Dugernier T et al. Insufficient -lactam concentrations in the early phase of severe sepsis and septic shock. Crit Care, 2010, 14: R126.

28. McKenzie C. Antibiotic dosing in critical illness. J Antimicrob Chemother, 2011, 66(Suppl 2): ii25–ii31.

29. Pinder M, Bellomo R, Lipman J. Pharmaco logical principles of antibiotic prescription in the critically ill. Anaesth Intensive Care, 2002, 30: 134–144.

30. Li C, Du X, Kuti JL, Nicolau DP. Clinical pharmacodynamics of meropenem in patients with lower respiratory tract infections. Antimicrob Agents Chemother, 2007, 51: 1725–1730.

31. Chen M, Nafziger AN, Drusano GL et al. Comparative pharmacokinetics and pharmaco-dynamic target attainment of ertapenem in normal-weight, obese, and extremely obese adults. Antimicrob Agents Chemother, 2006, 50: 1222–1227.

32. Hanley MJ, Abernethy DR, Greenblatt DJ. Effect of obesity on the pharmacokinetics of drugs in humans. Clin Pharmacokinet, 2010, 49: 71–87.

33. Higgins PG, Dammhayn C, Hackel M, Seifert H. Global spread of carbapenem-resistant Acinetobacter baumannii. J Antimicrob Chemother, 2010, 65: 233-8.

34. Poirel L, Nordmann P. Carbapenem resistance in Acinetobacter baumannii: mechanisms and epidemiology. Clin Microbiol Infect, 2006, 12: 826-36.

35. Maragakis LL, Perl TM. Acinetobacter baumannii: epidemiology, antimicrobial resistance, and treatment options. Clin Infect Dis, 2008, 46: 1254-63.

36. Karageorgopoulos DE, Kelesidis T, Kelesidis I, Falagas ME. Tigecycline for the treatment of multidrug-resistant (including carbapenem-resistant) Acinetobacter infections: a review of the scientific evidence. J Antimicrob Chemother, 2008, 62: 45-55.

37. Gordon NC and Wareham DW. Multidrug-resistant Acinetobacter baumannii: mechanisms of virulence and resistance. Int J Antimicrob Agents, 2010, 35: 219-26.

38. Park YK, Jung SI, Park KH et al. Independent emergence of colistin-resistant Acinetobacter spp. isolates from Korea. Diagn Microbiol Infect Dis, 2009, 64: 43-51.

39. Cai Y, Chai D, Wang R et al. Colistin resistance of Acinetobacter baumannii: clinical reports, mechanisms and antimicrobial strategies. J Antimicrob Chemother, 2012, 67: 1607-15.

40. Navon-Venezia S, Leavitt A, Carmeli Y. High tigecycline resistance in multidrug-resistant Acinetobacter baumannii. J Antimicrob Chemother, 2007, 59: 772-4.

41. Pankuch GA, Seifert H, Appelbaum PC. Activity of doripenem with and without levofloxacin, amikacin, and colistin against Pseudomonas aeruginosa and Acinetobacter baumannii. Diagn Microbiol Infect Dis, 2010, 67: 191-7.

42. Dinc G, Demiraslan H, Elmali F et al. Antimicrobial efficacy of doripenem and its combinations with sulbactam, amikacin, colis-tin, tigecycline in experimental sepsis of car-bapenem-resistant Acinetobacter baumannii. New Microbiol, 2015, 38: 67-73.

43. Park G, Choi J, Jang S et al. In Vitro Interactions of Antibiotic Combinations of Colistin, Tigecycline, and Doripenem Against Extensively Drug-Resistant and Multidrug-Resistant Acinetobacter baumannii. Ann Lab Med, 2016, 36: 124-130.