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Drug Regimen May Eradicate CRE ‘Superbug’

Researchers focus on gentamicin and colistin (November 25)

Orally administered, nonabsorbable antibiotics were effective in eradicating carbapenem-resistant Enterobacteriaceae (CRE) colonization, according to a new study published in the American Journal of Infection Control, a publication of the Association for Professionals in Infection Control and Epidemiology (APIC).

Researchers in Israel examined isolates from 152 patients who were identified as CRE carriers (colonized with the organism, but not yet showing disease) over a 24-month period. Fifty patients received one of three drug regimens based on the antibiotic sensitivities of their isolates: nonabsorbable gentamicin (n = 26), nonabsorbable colistin (n = 16), or a combination of the two (n = 8). The patients were treated until cultures were negative for CRE or for a maximum period of 60 days.

Patients who were not sensitive to either antibiotic or who did not give consent (n = 102) comprised the control group and were followed for a median period of 140 days to determine the spontaneous eradication rate.

CRE colonization was eradicated in 42% (11/26) of patients treated with gentamicin, in 50% (8/16) of those receiving colistin, and in 38% (3/8) of those receiving combined treatment, for an overall eradication rate of 44% (22/50) compared with a 7% (7/102) eradication rate in the control group.

“Treatment with oral nonabsorbable antibiotics to which CRE is susceptible appears to be safe and effective for eradication of the CRE carrier state,” say the researchers. “Reducing the reservoir of CRE carriers in health care facilities may thereby reduce patient-to-patient transmission and the incidence of clinical infection with this difficult-to-treat organism.”

Source: APIC; November 25, 2013.

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