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[β-内酰胺类抗生素]

[beta-Lactam antibiotics].

作者信息

Marín Mar, Gudiol Francesc

机构信息

Servicio de Enfermedades Infecciosas. Hospital de Bellvitge. Universidad de Barcelona. Hospitalet de Llobregat. Barcelona. España.

出版信息

Enferm Infecc Microbiol Clin. 2003 Jan;21(1):42-55. doi: 10.1016/s0213-005x(03)72873-0.

Abstract

Betalactams, which act by inhibiting the last phase of bacterial cell wall synthesis, constitute the largest family of antimicrobial agents and the most extensively used in current clinical practice. These drug have a slow bactericidal action that is relatively independent of plasma concentrations, little toxicity and a broad therapeutic margin. Their spectrum has increased over the years with the incorporation of new molecules having greater activity against gram-negative bacilli. Nevertheless, the progressive emergence of acquired resistance has limited the empirical use of betalactams and their efficacy in certain situations. Despite this problem, penicillin is still the treatment of choice for a large number of classic infections, cephalosporins are widely used in surgical prophylaxis and severe community-acquired infections, carbapenems are the choice for mixed nosocomial and multiresistant bacterial infections and betalactamase inhibitors permit the effective use of amino- and ureido-penicillins in highly significant infections.

摘要

β-内酰胺类药物通过抑制细菌细胞壁合成的最后阶段发挥作用,是最大的抗菌药物家族,也是目前临床实践中使用最广泛的药物。这些药物具有缓慢的杀菌作用,相对独立于血浆浓度,毒性小,治疗窗宽。多年来,随着对革兰氏阴性杆菌活性更强的新分子的加入,它们的抗菌谱有所增加。然而,获得性耐药的逐渐出现限制了β-内酰胺类药物的经验性使用及其在某些情况下的疗效。尽管存在这个问题,青霉素仍然是许多经典感染的首选治疗药物,头孢菌素广泛用于外科预防和严重的社区获得性感染,碳青霉烯类是混合医院感染和多重耐药细菌感染的首选药物,β-内酰胺酶抑制剂允许在严重感染中有效使用氨基青霉素和脲基青霉素。

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