Περίληψη:
Burkholderia cepacia complex (BCC) is an important group of pathogens
affecting patients with cystic fibrosis and chronic granulomatous
disease as well as immunocompromised and hospitalised patients.
Therapeutic options are limited owing to high levels of resistance of
the organism, either intrinsic or acquired, to many antimicrobial
agents. Co-trimoxazole (trimethoprim/sulfamethoxazole) has been a drug
of choice. However, in some cases it cannot be administered because of
allergic or hypersensitivity reactions, intolerance or resistance. We
systematically searched for relevant publications including clinical
data in PubMed and Scopus. The search identified 48 relevant case
reports (57 cases) and 8 cohort studies or trials. Nineteen (33.3%) of
57 patients included in the case reports received ceftazidime-based
regimens, 14 (73.7%) of whom were cured. Meropenem was administered in
seven patients (12.3%), one (14.3%) of whom improved and five (71.4%)
were cured. Seven (12.3%) of 57 cases were treated with penicillins,
four of which were piperacillin (all had a favourable outcome). Based on
the data reported in the eight relevant cohort studies or trials
identified, favourable outcomes were observed in 68.4% (26/38) to 100%
(16/16) of cases treated with ceftazidime and 66.7% (6/9) of cases
treated with meropenem. Also, 9/12 (75%) of patients receiving
penicillins improved. Thus, Ceftazidime, meropenem and penicillins,
mainly piperacillin, either alone or in combination with other
antimicrobial agents, may be considered as alternative options for BCC
infections, according to the in vitro antimicrobial susceptibility
patterns and clinical results. However, the available clinical data are
not sufficient and further clinical experience is required to clarify
the appropriateness of these antibiotics for BCC infections. (C) 2008
Elsevier B.V. and the International Society of Chemotherapy. All rights
reserved.
Συγγραφείς:
Avgeri, Sophia G.
Matthaiou, Dimitrios K.
Dimopoulos, George and
Grammatikos, Alexandros P.
Falagas, Matthew E.
