Hayashi I
Department of Internal Medicine, Cancer Institute Hospital.
Nihon Rinsho. 2001 Apr;59(4):761-70.
Glycopeptides(Vancomycin(VCM), Teicoplanin(TEIC)) are effective against Gram positive cocci(GPC) and mainly prescribing for Methicillin Resistant Staphylococcus aureus(MRSA) infection in Japan. Mode of actions are little bit difference between VCM and TEIC, for example the rate of protein binding, post antibiotic effect and half-life time. Effect of glycopeptide depend on the above MIC. To keep the effective serum concentrations of the drug, recommended the method of loading dose for TEIC and the method of continuous drip infusions for VCM. Also keep the effective serum concentrations shows to shorten the duration of treatment and to protect for development of resistant strains. Biofilm diseases caused by P. aeruginosa, MRSA and MRSE are treated by combination therapy with Fosfomycin(FOM). The most powerful intensive chemotherapy (FOM + Sulbactam/Cefoperazon + Glycopeptides) shows superior effects against multiple infections caused by P. aeruginosa and MRSA.
糖肽类药物(万古霉素(VCM)、替考拉宁(TEIC))对革兰氏阳性球菌(GPC)有效,在日本主要用于治疗耐甲氧西林金黄色葡萄球菌(MRSA)感染。VCM和TEIC的作用方式略有不同,例如蛋白结合率、抗生素后效应和半衰期。糖肽类药物的疗效取决于上述最低抑菌浓度(MIC)。为保持药物的有效血清浓度,推荐替考拉宁采用负荷剂量法,万古霉素采用持续滴注法。保持有效血清浓度还可缩短治疗时间并防止耐药菌株的产生。由铜绿假单胞菌、MRSA和耐甲氧西林表皮葡萄球菌(MRSE)引起的生物被膜疾病通过与磷霉素(FOM)联合治疗。最有效的强化化疗(FOM + 舒巴坦/头孢哌酮 + 糖肽类药物)对由铜绿假单胞菌和MRSA引起的多重感染显示出更好的效果。