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J Korean Med Assoc > Volume 61(4); 2018 > Article
Journal of the Korean Medical Association 2018;61(4):281-289.
Published online April 19, 2018.
DOI: https://doi.org/10.5124/jkma.2018.61.4.281   
Carbapenem-resistant Enterobacteriaceae: recent updates and treatment strategies
Hyo Jin Lee, Dong Gun Lee
1Division of Infectious Diseases, Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea. symonlee@catholic.ac.kr
2Vaccine Bio-Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea.
The emergence of carbapenem-resistant Enterobacteriaceae (CRE) has become a major problem within the field of healthcare-associated infections worldwide in the last decade. The treatment of infections caused by CRE is challenging, and a consensus strategy has not been established. This article reviews old and new antibiotics for the treatment of CRE, and summarizes the overall mechanisms of resistance, epidemiology, diagnosis, and infection control of CRE. For CRE treatment, combination therapies may be preferred. Carbapenem still plays an important role in CRE treatment. Other existing treatment options against CRE include colistin, tigecycline, fosfomycin, and aminoglycosides. New therapeutic options include ceftazidime-avibactam, aztreonam-avibactam, plazomicin, eravacycline, meropenem-vaborbactam, and imipenem-cilastatin-relebactam. Few randomized controlled trials have been conducted, so more studies of new agents against CRE are needed. Because there are relatively few therapeutic options for CRE, adequate infection prevention measures and antimicrobial stewardship are required. Moreover, both personal and national preventive efforts are needed.
Key Words: Carbapenem-resistant Enterobacteriaceae, Therapeutics, Carbapenemase, Korea


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