Török M Estee, Chapman Ann L N, Lessing M P Albert, Sanderson Frances, Seaton R Andrew
Cambridge University Hospitals NHS Foundation Trust, Department of Infectious Diseases, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0QQ, UK.
Curr Opin Investig Drugs. 2010 Aug;11(8):929-39.
Patients with serious infections requiring parenteral antimicrobial therapy are usually hospitalized for treatment. For certain conditions, however, administration of parenteral antibiotics outside the hospital setting may be safe, efficacious, convenient for patients and cost-beneficial. Outpatient parenteral antimicrobial therapy (OPAT) was developed in the US initially and its use has expanded globally during the past three decades. A wide variety of infections are amenable to treatment by OPAT. Once-daily agents such as ceftriaxone or teicoplanin and, more recently, antimicrobials such as ertapenem or daptomycin have been used for OPAT. The use of higher doses and less-frequent dosing of existing agents is being explored, and exciting new developments include the emergence of agents with broader-spectrum activity against drug-resistant organisms and the use of antifungal agents in the OPAT setting. Future prospects in OPAT include the use of more recently launched drugs such as telavancin, as well as drugs in development, including dalbavancin (Durata Therapeutics Inc) and omadacycline (PTK-0796; Novartis AG/PARATEK Pharmaceuticals Inc). This review outlines recent developments in, and future prospects for, the antimicrobial agents used in OPAT.
需要肠外抗菌治疗的严重感染患者通常需住院治疗。然而,对于某些情况,在医院外给予肠外抗生素可能是安全、有效的,对患者方便且具有成本效益。门诊肠外抗菌治疗(OPAT)最初在美国开展,在过去三十年中其应用已在全球范围内扩大。多种感染适合采用OPAT治疗。每日一次给药的药物如头孢曲松或替考拉宁,以及最近的抗菌药物如厄他培南或达托霉素已用于OPAT。目前正在探索使用更高剂量和更少给药频率的现有药物,令人兴奋的新进展包括出现了对耐药菌具有更广泛抗菌活性的药物以及在OPAT环境中使用抗真菌药物。OPAT的未来前景包括使用最近推出的药物如特拉万星,以及正在研发的药物,包括达巴万星(杜拉塔治疗公司)和奥玛环素(PTK - 0796;诺华公司/帕拉特克制药公司)。本综述概述了OPAT中使用的抗菌药物的最新进展和未来前景。