Peterson L R
Northwestern University's Feinberg School of Medicine, Departments of Medicine and Pathology, Chicago, IL, USA.
Clin Microbiol Infect. 2008 Dec;14 Suppl 6:30-45. doi: 10.1111/j.1469-0691.2008.02125.x.
Infectious diseases remain a serious and now re-emerging threat to human life, contributing to over ten million deaths per year. Treatment of major infectious diseases with antibacterial agents creates an ongoing and escalating public health issue that currently leads to more problems than solutions. By processes of adaptation and survival, bacteria consistently develop mechanisms to overcome the effects of the newest and most potent antibacterial compounds. Simultaneously, progressively fewer antibacterial agents are being developed by pharmaceutical and biotechnology companies. Although this dilemma is an inherent trade-off and has no imminent resolution, the most prudent paradigm to pursue is the judicious use of antibacterial agents in the most limited way possible to attain the desired treatment results. One straightforward approach to antimicrobial stewardship is to use a single agent as opposed to combination therapy, so as to subject bacteria to lower total antibiotic exposure whenever feasible. This article reviews current trends in antibacterial drug development and describes a context for adherence to monotherapy with newer agents.
传染病仍然是对人类生命的严重且再度出现的威胁，每年导致超过一千万人死亡。使用抗菌剂治疗主要传染病引发了一个持续且不断升级的公共卫生问题，目前导致的问题比解决的问题更多。通过适应和生存过程，细菌不断发展出克服最新和最有效抗菌化合物作用的机制。与此同时，制药和生物技术公司研发的抗菌剂越来越少。尽管这种困境是一种内在的权衡，且没有紧迫的解决方案，但最谨慎的做法是尽可能以最有限的方式明智地使用抗菌剂，以获得理想的治疗效果。抗菌药物管理的一个直接方法是使用单一药物而非联合治疗，以便在可行时使细菌接触更低的总抗生素剂量。本文回顾了抗菌药物研发的当前趋势，并描述了坚持使用新型药物进行单药治疗的背景。
