Stratton Charles W
Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Postgrad Med. 2002 Sep;112(3 Suppl):7-11. doi: 10.3810/pgm.09.2002.suppl19.103.
The problem of antibiotic resistance continues to undermine the prospects for effective treatment of community-acquired respiratory tract infections in the United States and around the world. A new international surveillance initiative, the Prospective Resistant Organism Tracking and Epidemiology for the Ketolide Telithromycin (PROTEKT) study, is collecting data on the resistance of common respiratory pathogens to antibacterial drugs in 25 countries. This study also affords the opportunity to examine bacterial susceptibility to telithromycin, the first agent in a new category of antibacterials, the ketolides. The US portion of this program (PROTEKT US) was launched in 2000 and has yielded preliminary data on the national and regional antibiotic susceptibility of Streptococcus pneumoniae, the most important respiratory tract pathogen in treatment resistance and associated adverse outcomes. Thus far, analyses from PROTEKT US have revealed substantial rates of resistance of S pneumoniae to beta-lactams and macrolides, as well as emerging resistance to fluoroquinolones. However, fully 100% of the isolates examined have been susceptible to telithromycin. This agent, which is available in Europe and should become available for clinical use in the United States soon, appears to hold promise for meeting the challenge of antibiotic resistance.
抗生素耐药性问题持续破坏美国乃至全球有效治疗社区获得性呼吸道感染的前景。一项新的国际监测计划——酮内酯类药物泰利霉素前瞻性耐药病原体追踪与流行病学研究（PROTEKT），正在收集25个国家常见呼吸道病原体对抗菌药物耐药性的数据。该研究还提供了一个机会，来检测细菌对泰利霉素的敏感性，泰利霉素是新型抗菌药物——酮内酯类中的首个药物。该项目的美国部分（PROTEKT美国）于2000年启动，已得出关于肺炎链球菌全国及地区抗生素敏感性的初步数据，肺炎链球菌是治疗耐药性及相关不良后果方面最重要的呼吸道病原体。到目前为止，PROTEKT美国的分析显示，肺炎链球菌对β-内酰胺类和大环内酯类药物有很高的耐药率，对氟喹诺酮类药物的耐药性也在不断出现。然而，所检测的分离株中有整整100%对泰利霉素敏感。这种药物在欧洲已有供应，在美国也应很快可供临床使用，它似乎有望应对抗生素耐药性的挑战。
