Infectious Diseases in the Intensive Care Unit by Unknown

Author:Unknown
Language: eng
Format: epub
ISBN: 9789811540394
Publisher: Springer Singapore

14.8 Future Directions

Emergence of MDRO is the challenge facing intensivists, oncologists, and hemato-oncologists dealing with neutropenic sepsis. Recent review questions the utility of prophylaxis in patients with anticipated neutropenia in the absence of strong evidence to support the same, fearing selection of resistant strains (Calitri et al. 2018). Recent study favors a review in antibiotic within 24 h, considering the fact that 92.1% of the positive blood culture are seen within this period and none of the MDRs grow after this 24 h bracket (Puerta-Alcalde et al. 2019). In the quest to tackle the MDROs, newer formulations of cephalosporine like the siderophore cefiderocol (Dobias et al. 2017), and combinations of new β-lactamase inhibitors with carbapenems and cephalosporins has shown promising results (Castanheira et al. 2017; Marshall et al. 2017; Gonzalez et al. 2017; Karlowsky et al. 2018). Development of newer class of antibacterials is an imminent need to strengthen the armamentarium against these resistant organisms.

References

Aarts MJ, Peters FP, Mandigers CM, Dercksen MW, Stouthard JM, Nortier HJ, et al. Primary granulocyte colony-stimulating factor prophylaxis during the first two cycles only or throughout all chemotherapy cycles in patients with breast cancer at risk for febrile neutropenia. J Clin Oncol. 2013;31(34):4290–6.PubMed

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