Antibiotics in Necrotizing Soft Tissue Infections.
anti-toxinic
antibiotic
beta-lactam
clindamycin
necrotizing soft tissue infections
pharmacodynamics
pharmacokinetics
piperacillin-tazobactam
tissue diffusion
Journal
Antibiotics (Basel, Switzerland)
ISSN: 2079-6382
Titre abrégé: Antibiotics (Basel)
Pays: Switzerland
ID NLM: 101637404
Informations de publication
Date de publication:
13 Sep 2021
13 Sep 2021
Historique:
received:
27
08
2021
revised:
08
09
2021
accepted:
10
09
2021
entrez:
28
9
2021
pubmed:
29
9
2021
medline:
29
9
2021
Statut:
epublish
Résumé
Necrotizing soft tissue infections (NSTIs) are rare life-threatening bacterial infections characterized by an extensive necrosis of skin and subcutaneous tissues. Initial urgent management of NSTIs relies on broad-spectrum antibiotic therapy, rapid surgical debridement of all infected tissues and, when present, treatment of associated organ failures in the intensive care unit. Antibiotic therapy for NSTI patients faces several challenges and should (1) carry broad-spectrum activity against gram-positive and gram-negative pathogens because of frequent polymicrobial infections, considering extended coverage for multidrug resistance in selected cases. In practice, a broad-spectrum beta-lactam antibiotic (e.g., piperacillin-tazobactam) is the mainstay of empirical therapy; (2) decrease toxin production, typically using a clindamycin combination, mainly in proven or suspected group A streptococcus infections; and (3) achieve the best possible tissue diffusion with regards to impaired regional perfusion, tissue necrosis, and pharmacokinetic and pharmacodynamic alterations. The best duration of antibiotic treatment has not been well established and is generally comprised between 7 and 15 days. This article reviews the currently available knowledge regarding antibiotic use in NSTIs.
Identifiants
pubmed: 34572686
pii: antibiotics10091104
doi: 10.3390/antibiotics10091104
pmc: PMC8466904
pii:
doi:
Types de publication
Journal Article
Review
Langues
eng
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