Аннотация
В настоящее время карбапенемы (имипенем, меропенем, эртапенем) остаются одним из тех классов антибиотиков, которые обладают наиболее широким спектром активности и характеризуются низкой устойчивостью к ним клинически значимых микроорганизмов. Данная статья представляет собой попытку как определить место в клинической практике карбапенемов в целом, так и проанализировать различия между отдельными препаратами по их основным характеристикам. Для решения этой задачи рассмотрены опубликованные более чем за 20 лет микробиологические и клинические данные по карбапенемам и проведён их критический анализ по определённому алгоритму. На основании данных рандомизированных контролируемых исследований и существующих метаанализов проведено сравнение карбапенемов с точки зрения клинической эффективности при внебольничных и нозокомиальных инфекциях, тяжёлых и нетяжёлых инфекциях, применение в виде моно- и комбинированной терапии. Особое внимание уделено анализу современных данных по резистентности клинически значимых возбудителей к карбапенемам в сравнении с другими группами препаратов. Приведены мнения экспертов и данные согласительных документов по таким вопросам, как выбор препарата, показания к применению.
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