Shanson D C
Department of Microbiology, Charing Cross and Westminster Medical School, London, UK.
J Antimicrob Chemother. 1990 Feb;25 Suppl B:15-21. doi: 10.1093/jac/25.suppl_b.15.
The clinical relevance of resistance to fusidic acid in Staphylococcus aureus is reviewed. Resistance due to a one-step chromosomal mutation emerges readily in vitro. These variants appear defective and are not encountered clinically as frequently as would be expected. The majority of strains isolated from patients probably have plasmid-mediated resistance. The plasmid may be unstable both in vitro and in vivo. There appears to be a low incidence of resistance emerging when fusidic acid is used alone to treat acute infections; however, there is a higher incidence in chronic infections. When fusidic acid is given concurrently with another antibacterial agent to treat severe infection, resistance may be acquired in up to 1% of cases. The use of fusidic acid topically to treat acute skin infection in domiciliary practice does not appear to be epidemiologically hazardous. Over the last 20 years, during which fusidic acid has been used widely in the management of staphylococcal infection, the general level of resistance has remained low at 1-2%.
本文综述了金黄色葡萄球菌对夫西地酸耐药的临床相关性。一步染色体突变导致的耐药性在体外很容易出现。这些变体似乎有缺陷，在临床上出现的频率不如预期的高。从患者中分离出的大多数菌株可能具有质粒介导的耐药性。该质粒在体外和体内可能都不稳定。单独使用夫西地酸治疗急性感染时，耐药性出现的发生率似乎较低；然而，在慢性感染中发生率较高。当夫西地酸与另一种抗菌剂同时用于治疗严重感染时，高达1%的病例可能会获得耐药性。在家庭医疗中局部使用夫西地酸治疗急性皮肤感染似乎在流行病学上没有危害。在过去20年里，夫西地酸被广泛用于葡萄球菌感染的治疗，总体耐药水平一直较低，为1%-2%。
