多项研究结果显示应用氟喹诺酮类抗生素和β-内酰胺类(如阿莫西林/克拉维酸、第三代头孢菌素或亚胺培南)抗生素是导致多重耐药铜绿假单胞菌医院感染的危险因素。鉴于上述两种细菌中的多重耐药株和泛耐药株感染缺乏有效治疗药物,因此专家指出在细菌耐药性监测中除调查细菌对不同抗菌药的耐药率外,尤应重视多重耐药株和泛耐药株的发生率[9]医.学.全.在.线www.lindalemus.com。
由于缺乏新的治疗药物,多重耐药铜绿假单胞菌和鲍曼不动杆菌的治疗方案不甚理想。尽管多黏菌素及黏菌素类是治疗铜绿假单胞菌或鲍曼不动杆菌感染的最后选择,但已有耐药株出现;最新的研究报道显示已有多种联合治疗方案体外试验有效,也有被证实临床有效的方案,如:黏菌素与利福平、米诺环素、头孢他啶联合;亚胺培南和阿米卡星或利福平联合;黏菌素、左氧氟沙星、丁胺卡那霉素联合;亚胺培南,哌拉西林/他唑巴坦联合等[10-12],故相信双重甚至三重抗菌药物组合的联合用药将是未来可选择方案。
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