Deresinski Stan
Division of Infectious Disease and Geographic Medicine, Department of Medicine, Stanford University, CA, USA.
Clin Infect Dis. 2007 Jun 15;44(12):1543-8. doi: 10.1086/518452. Epub 2007 May 4.
The efficacy of vancomycin for the treatment of patients with infections due to Staphylococcus aureus is impaired by its poor tissue penetration and by its relatively weak antibacterial activity--an activity that is declining as S. aureus evolves. Neither dose escalation nor use of vancomycin in combination with other antibiotics that have antistaphylcoccal activity has been demonstrated to safely enhance its therapeutic efficacy. Although no clinical trials suggest superiority of vancomycin over any comparator, some have provided evidence of its inferiority. Strong consideration should be given to the use of alternative agents in the treatment of serious S. aureus infections.
万古霉素对金黄色葡萄球菌感染患者的治疗效果因组织穿透力差和抗菌活性相对较弱而受到影响，且随着金黄色葡萄球菌的进化，其抗菌活性正在下降。剂量增加或与其他具有抗葡萄球菌活性的抗生素联合使用万古霉素，均未被证明能安全提高其治疗效果。尽管没有临床试验表明万古霉素优于任何对照药物，但一些试验已提供了其疗效较差的证据。在治疗严重金黄色葡萄球菌感染时，应慎重考虑使用替代药物。
