Neuner Elizabeth A, Ritchie David J, Micek Scott T
Department of Pharmacy, Barnes-Jewish Hospital, St. Louis, Missouri 63110, USA.
Semin Respir Crit Care Med. 2009 Feb;30(1):92-101. doi: 10.1055/s-0028-1119813. Epub 2009 Feb 6.
Current antibiotics available for the treatment of healthcare-associated pneumonia (HCAP) may result in clinical failure due to resistance development, side effect intolerance, or poor pharmacokinetic-pharmacodynamic profiles. New agents active against common HCAP pathogens are needed. The mechanism of action, spectrum of activity, pharmacokinetics, adverse effects, and clinical efficacy of seven new agents in clinical development or recently approved with either methicillin-resistant Staphylococcus aureus (MRSA) or pseudomonal activity are reviewed. They include doripenem, a new antipseudomonal carbapenem; ceftobiprole and ceftaroline, two anti-MRSA cephalosporins; iclaprim, a selective dihydrofolate reductase antagonist; and three glycopeptides, dalbavancin, telavancin, and oritavancin.
目前可用于治疗医疗保健相关肺炎(HCAP)的抗生素可能会因耐药性产生、副作用不耐受或药代动力学-药效学特性不佳而导致临床治疗失败。因此需要对常见HCAP病原体有效的新型药物。本文综述了七种正在临床开发或最近已获批的、对耐甲氧西林金黄色葡萄球菌(MRSA)或假单胞菌有活性的新型药物的作用机制、活性谱、药代动力学、不良反应和临床疗效。它们包括新型抗假单胞菌碳青霉烯类药物多黏菌素;两种抗MRSA头孢菌素头孢洛林和头孢托罗;选择性二氢叶酸还原酶拮抗剂伊克拉环素;以及三种糖肽类药物达巴万星、替考拉宁和奥利万星。