Enoch David A, Bygott Jeanine M, Daly Marie-Louise, Karas J Andreas
Clinical Microbiology and Public Health Laboratory, Health Protection Agency East of England, Papworth Hospital, Papworth Everard, Cambridgeshire, UK.
J Infect. 2007 Sep;55(3):205-13. doi: 10.1016/j.jinf.2007.05.180. Epub 2007 Jul 16.
There has been a steady rise in the prevalence of resistant Gram-positive pathogens and concerns about the clinical effectiveness of glycopeptides in treating infections due to Staphylococcus aureus. Daptomycin is a novel lipopeptide antimicrobial agent with activity against Gram-positive organisms, including multi-resistant strains. It is licensed in the USA and Europe for the treatment of complicated skin and soft tissue infections caused by Gram-positive organisms at a dose of 4mg/kg once daily. It has also been licensed in the USA for the treatment of S. aureus bacteraemia and right-sided endocarditis at 6mg/kg once daily. It is a safe and well-tolerated antibiotic, particularly at the current dosing regimen. Antimicrobial resistance, whilst being increasingly reported, still remains relatively rare. Further studies are required to determine the role of daptomycin for the treatment of osteomyelitis and septic arthritis, as well as its use in combination therapy.
耐革兰氏阳性病原体的患病率一直在稳步上升，人们也越来越担心糖肽类药物治疗金黄色葡萄球菌感染的临床效果。达托霉素是一种新型脂肽类抗菌药物，对革兰氏阳性菌具有活性，包括多重耐药菌株。在美国和欧洲，它被批准用于治疗由革兰氏阳性菌引起的复杂性皮肤和软组织感染，剂量为每日4mg/kg。在美国，它也被批准用于治疗金黄色葡萄球菌菌血症和右侧心内膜炎，剂量为每日6mg/kg。它是一种安全且耐受性良好的抗生素，特别是在目前的给药方案下。虽然越来越多地报道了抗菌药物耐药性，但仍然相对少见。需要进一步研究以确定达托霉素在治疗骨髓炎和脓毒性关节炎中的作用，以及其在联合治疗中的应用。
