Karbapenemlerin ve Monobaktamların Etki Spektrumu ve Kullanım Alanları
Özet
Karbapenemler en geniş spektrumlu beta laktam grubu antibiyotiklerdir. Özellikle dirençli ve ciddi yoğun bakım enfeksiyonlarında kullanılmaktadır. Artan antibiyotik direnci nedeniyle bu antibiyotiklerin günlük pratikte kullanımı artmıştır. Ancak son yıllarda karbapenem direncindeki artış ciddi sorun haline gelmiştir. Karbapenem grubu antibiyotiklerin beta-laktamaz grubu antibiyotikler ile kombinasyonu sonucunda etki spektrumu daha da genişletilmiştir. Günümüzde meropenem-vaborbaktam ve imipenem/silastatin-relebaktam umut vadetmektedir. Aztreonam etki mekanizması olarak beta laktam grubu ile benzerdir. Ancak etki spektrumu sadece gram negatif aerob bakterileri kapsamaktadır. Aztreonamın avibaktam ile kombinasyonu ile etki spektrumu genişletilmiştir. Bu bölümde karbapenemlerın ve monobaktamların etki mekanizmaları ve güncel kullanım alanları ele alınacaktır.
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