Аннотация
В обзоре литературы проанализированы результаты микробиологических, клинических и фармакоэкономических исследований карбапенемов. Показано, что два десятилетия использования карбапенемов не привели к значимому росту к ним резистентности клинически значимых микроорганизмов, за исключением Pseudomonas aeruginosa. По своей эффективности при инфекциях разной локализации карбапенемы не уступают, а нередко превосходят препараты сравнения, использующиеся как в режиме монотерапии, так и в комбинациях. Несмотря на высокую закупочную стоимость, в ходе фармакоэкономических исследований неоднократно демонстрировалось преимущество карбапенемов над более дешёвыми антибиотиками. Отношение к карбапенемам как к антибиотикам резерва изживает себя, поскольку неадекватная эмпирическая антибактериальная терапия, особенно при тяжёлых инфекциях, сопровождается статистически значимым увеличением летальности. Основными направлениями оптимизации использования карбапенемов являются внедрение в клиническую практику принципов деэскалационной терапии и назначение препаратов в оптимальных дозах.
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