Poissy Julien, Senneville Eric
Service d'Urgence Respiratoire et de Réanimation Médicale, Hôpital Calmette, CHRU de Lille, Bd du Pr Leclercq, 59037 Lille Cedex, France.
Infect Disord Drug Targets. 2011 Aug;11(4):401-12. doi: 10.2174/187152611796504854.
Infection is a major cause of morbidity and mortality in intensive care units (ICU). The impact on prognostic of an inadequate antibiotic therapy is well established. The problem is due to the growing spread of resistant microorganisms, including both Gram-negative and Gram-positive pathogens, especially in the case of ICU-acquired infections. In this context, antibiotics with broad spectrum activity are usually required. Moreover, these antibiotics should reach high concentrations in tissues, especially in lungs, and should exert a bactericidal activity for the most severely ill patients, especially those with bloodstream infections. A frequent problem in clinical practice is the lack of data validating their use in the context of critically ill patients. In the present article, we review the newest antibiotics that could be of interest for severe ICU-acquired infections: tigecycline, moxifloxacine, the newer carbapenems, linezolide and daptomycine. We discuss their approved indications and identify the fields in which they could be used to treat infections acquired in the ICU.
感染是重症监护病房（ICU）发病和死亡的主要原因。抗生素治疗不足对预后的影响已得到充分证实。问题在于耐药微生物的传播日益广泛，包括革兰氏阴性菌和革兰氏阳性病原体，尤其是在ICU获得性感染的情况下。在这种情况下，通常需要具有广谱活性的抗生素。此外，这些抗生素应在组织中，尤其是肺部达到高浓度，并应对最危重的患者，尤其是血流感染患者发挥杀菌活性。临床实践中一个常见的问题是缺乏在重症患者中验证其使用的数据。在本文中，我们综述了可能对严重的ICU获得性感染有意义的最新抗生素：替加环素、莫西沙星、新型碳青霉烯类、利奈唑胺和达托霉素。我们讨论了它们的批准适应症，并确定了可用于治疗ICU获得性感染的领域。
