A Perspective on Combination of Antibiotic Therapy for Extensively Drug-Resistance Bacterial Infections

Abstract

Evaluation of clinical efficacy in epidemiological studies and even controlled studies with extensively drug-resistant (XDR) organisms is difficult, as it generally encompasses critically ill patients, who are usually prone to high mortality rate. Combination therapy has been used as a strategy to establish synergistic effect. However, the literature has been extremely controversial, and most recent studies have demonstrated that combination therapy should not be used routinely in XDR bacterial infections. This narrative review discusses the combination therapy on XDR bacteria using the pharmacokinetic and pharmacodynamic approach based on several systematic reviews with meta-analysis.