Unorthodox Parenteral β-Lactam and β-Lactamase Inhibitor Combinations: Flouting Antimicrobial Stewardship and Compromising Patient Care.
In India and China, indigenous drug manufacturers market arbitrarily combined parenteral β-lactam and β-lactamase inhibitors (BL-BLIs). In these fixed-dose combinations, sulbactam or tazobactam is indiscriminately combined with parenteral cephalosporins, with BLI doses kept in ratios similar to those for the approved BL-BLIs. Such combinations have been introduced into clinical practice without mandatory drug development studies involving pharmacokinetic/pharmacodynamic, safety, and efficacy assessments being undertaken. Such unorthodox combinations compromise clinical outcomes and also potentially contribute to resistance development.
['Palwe|Snehal|S|', 'Veeraraghavan|Balaji|B|', 'Periasamy|Hariharan|H|', 'Khobragade|Kshama|K|', 'Kharat|Arun S|AS|']
D000151:Acinetobacter Infections D040981:Acinetobacter baumannii D000900:Anti-Bacterial Agents D000073602:Antimicrobial Stewardship D002511:Cephalosporins D002681:China D004338:Drug Combinations D000076064:Drug Misuse D024901:Drug Resistance, Multiple, Bacterial D004755:Enterobacteriaceae D004756:Enterobacteriaceae Infections D006801:Humans D057970:Inappropriate Prescribing D007194:India D008826:Microbial Sensitivity Tests D005791:Patient Care D011552:Pseudomonas Infections D011550:Pseudomonas aeruginosa D013407:Sulbactam D000078142:Tazobactam D065093:beta-Lactamase Inhibitors
β-lactam β-lactamase inhibitor antimicrobial stewardship unorthodox combinations fixed-dose antibiotic combinations irrational combinations