Early Multicenter Experience With Imipenem-Cilastatin-Relebactam for Multidrug-Resistant Gram-Negative Infections

Rebold, Nicholas; Morrisette, Taylor; Lagnf, Abdalhamid M; Alosaimy, Sara; Holger, Dana; Barber, Katie E.; Justo, Julie Ann; Antosz, Kayla; Carlson, Travis J; Frens, Jeremy J; Biagi, Mark; Kufel, Wesley D; Moore, William J; Mercuro, Nicholas J; Raux, Brian R.

doi:10.1093/ofid/ofab554

Cited by 24 publications

(19 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…An antibiotic-associated adverse event is less frequent in patients who received imipenem-cilastatin-relebactam compared with imipenem-cilastatin plus colistin (16.1% vs. 31.3%), including treatment-related nephrotoxicity (10% vs. 56%). A recent case series of 21 patients treated with imipenem-cilastatin-relebactam for mixed types of infections (mostly pneumonia) caused predominantly by MDR P. aeruginosa confirmed a high survival rate and a low rate of adverse events with imipenem-cilastatin-relebactam therapy [ 183 ]. Imipenem-cilastatin-relebactam is most recently approved BLBLI combination for the treatment of cUTIs, cIAIs, and HAP/VAP [ 184 , 185 ].…”

Section: Novel Blblismentioning

confidence: 99%

The Role of Colistin in the Era of New β-Lactam/β-Lactamase Inhibitor Combinations

Aslan

Akova

2022

Antibiotics

View full text Add to dashboard Cite

With the current crisis related to the emergence of carbapenem-resistant Gram-negative bacteria (CR-GNB), classical treatment approaches with so-called “old-fashion antibiotics” are generally unsatisfactory. Newly approved β-lactam/β-lactamase inhibitors (BLBLIs) should be considered as the first-line treatment options for carbapenem-resistant Enterobacterales (CRE) and carbapenem-resistant Pseudomonas aeruginosa (CRPA) infections. However, colistin can be prescribed for uncomplicated lower urinary tract infections caused by CR-GNB by relying on its pharmacokinetic and pharmacodynamic properties. Similarly, colistin can still be regarded as an alternative therapy for infections caused by carbapenem-resistant Acinetobacter baumannii (CRAB) until new and effective agents are approved. Using colistin in combination regimens (i.e., including at least two in vitro active agents) can be considered in CRAB infections, and CRE infections with high risk of mortality. In conclusion, new BLBLIs have largely replaced colistin for the treatment of CR-GNB infections. Nevertheless, colistin may be needed for the treatment of CRAB infections and in the setting where the new BLBLIs are currently unavailable. In addition, with the advent of rapid diagnostic methods and novel antimicrobials, the application of personalized medicine has gained significant importance in the treatment of CRE infections.

show abstract

Section: Novel Blblismentioning

confidence: 99%

The Role of Colistin in the Era of New β-Lactam/β-Lactamase Inhibitor Combinations

Aslan

Akova

2022

Antibiotics

View full text Add to dashboard Cite

show abstract

“…In the chapters to follow, the novel β-lactamase inhibitors combination currently in the market (i.e., ceftazidime/avibactam, meropenem-vaborbactam, imipenem-cilastatin-relebactam) and the forthcoming aztreonam-avibactam are presented and discussed, focusing mainly on clinical issues dealing with DTR pathogens in critically ill patients and ICU patients, illustrated in Table 1 . Mechanism of action, spectrum of activity, mechanism of resistance, approved indications, and information on DTR and PDR Gram-negative pathogens are depicted in Table 1 [ 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 ,…”

Section: Carbapenem-resistant Klebsiella Pneumoniaementioning

confidence: 99%

“…The most prevalent pathogen was P. aeruginosa (16/21, 76%). Clinical cure occurred in 13/21 (62%) of patients treated with imipenem-cilastatin-relebactam, whereas mortality occurred in 33% (7/21) of patients [ 50 ]. The IDSA guidance on the treatment of P. aeruginosa with difficult-to-treat resistance suggests imipenem-cilastatin-relebactam therapy for cystitis, pyelonephritis, or cUTI, as well as for infections outside of the urinary tract [ 25 ].…”

Section: Pseudomonas Aeruginosa With Difficult-to-treat Resi...mentioning

confidence: 99%

Current and Potential Therapeutic Options for Infections Caused by Difficult-to-Treat and Pandrug Resistant Gram-Negative Bacteria in Critically Ill Patients

Giamarellou

Karaiskos

2022

Antibiotics

View full text Add to dashboard Cite

Carbapenem resistance in Gram-negative bacteria has come into sight as a serious global threat. Carbapenem-resistant Gram-negative pathogens and their main representatives Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa are ranked in the highest priority category for new treatments. The worrisome phenomenon of the recent years is the presence of difficult-to-treat resistance (DTR) and pandrug-resistant (PDR) Gram-negative bacteria, characterized as non-susceptible to all conventional antimicrobial agents. DTR and PDR Gram-negative infections are linked with high mortality and associated with nosocomial infections, mainly in critically ill and ICU patients. Therapeutic options for infections caused by DTR and PDR Gram-negative organisms are extremely limited and are based on case reports and series. Herein, the current available knowledge regarding treatment of DTR and PDR infections is discussed. A focal point of the review focuses on salvage treatment, synergistic combinations (double and triple combinations), as well as increased exposure regimen adapted to the MIC of the pathogen. The most available data regarding novel antimicrobials, including novel β-lactam-β-lactamase inhibitor combinations, cefiderocol, and eravacycline as potential agents against DTR and PDR Gram-negative strains in critically ill patients are thoroughly presented.

show abstract

“…Interestingly, 28-day all-cause mortality was 20% lower with imipenem/cilastatin/relebactam (9.5% versus 30%, adjusted difference, –17.3%; 90% CI, –46.4–6.7%) [ 77 ]. Of the 47 patients belonging to the overall population, 45 had enough data to assess nephrotoxicity: no patients undergoing imipenem/cilastatin/relebactam experienced kidney failure according to Risk, Injury, Failure, Loss, and End-stage Kidney Disease (RIFLE) criteria, as opposed to the group undergoing imipenem plus colistin (25%) [ 80 ].…”

Section: Available Treatments For Carbapenem-resistant Gram-negative ...mentioning

confidence: 99%

Epidemiology, Mechanisms of Resistance and Treatment Algorithm for Infections Due to Carbapenem-Resistant Gram-Negative Bacteria: An Expert Panel Opinion

et al. 2022

View full text Add to dashboard Cite

Antimicrobial resistance represents a serious threat for global health, causing an unacceptable burden in terms of morbidity, mortality and healthcare costs. In particular, in 2017, carbapenem-resistant organisms were listed by the WHO among the group of pathogens for which novel treatment strategies are urgently needed. Fortunately, several drugs and combinations have been introduced in recent years to treat multi-drug-resistant (MDR) bacteria. However, a correct use of these molecules is needed to preserve their efficacy. In the present paper, we will provide an overview on the epidemiology and mechanisms of resistance of the most common MDR Gram-negative bacteria, proposing a treatment algorithm for the management of infections due to carbapenem-resistant bacteria based on the most recent clinical evidence.

show abstract

Early Multicenter Experience With Imipenem-Cilastatin-Relebactam for Multidrug-Resistant Gram-Negative Infections

Cited by 24 publications

References 21 publications

The Role of Colistin in the Era of New β-Lactam/β-Lactamase Inhibitor Combinations

The Role of Colistin in the Era of New β-Lactam/β-Lactamase Inhibitor Combinations

Current and Potential Therapeutic Options for Infections Caused by Difficult-to-Treat and Pandrug Resistant Gram-Negative Bacteria in Critically Ill Patients

Epidemiology, Mechanisms of Resistance and Treatment Algorithm for Infections Due to Carbapenem-Resistant Gram-Negative Bacteria: An Expert Panel Opinion

Contact Info

Product

Resources

About