Open AccessUnorthodox Parenteral β-Lactam and β-Lactamase Inhibitor Combinations: Flouting Antimicrobial Stewardship and Compromising Patient Care
Author(s) -
Snehal Palwe,
Balaji Veeraraghavan,
Hariharan Periasamy,
Kshama Khobragade,
Arun S. Kharat
Publication year - 2020
Publication title -
antimicrobial agents and chemotherapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.07
H-Index - 259
eISSN - 1070-6283
pISSN - 0066-4804
DOI - 10.1128/aac.00168-20
Subject(s) - sulbactam , pharmacodynamics , cephalosporin , medicine , beta lactamase inhibitors , piperacillin/tazobactam , pharmacokinetics , pharmacology , antibiotics , intensive care medicine , piperacillin , microbiology and biotechnology , biology , pseudomonas aeruginosa , bacteria , antibiotic resistance , imipenem , genetics
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.