Center for Anti-Infective Agents, Eckpergasse 13, 1180 Vienna, Austria.
Curr Opin Pharmacol. 2011 Oct;11(5):433-8. doi: 10.1016/j.coph.2011.07.008. Epub 2011 Aug 19.
New resistance challenges continue to evolve and spread worldwide. In an otherwise mature field, antibacterial drug development is primarily driven by resistance trends with a focus on development of new analogs of known scaffolds to strengthen them against class-specific resistance mechanisms. Currently new analogs of cephalosporins (with or without beta-lactamase inhibitors), oxazolidinones, glycopeptides, quinolones, aminoglycosides, tetracyclines, and ketolides are in clinical studies. While showing some benefit, these new analogs only partially address the clinical crisis of multidrug-resistant pathogens; this is especially the case for Gram-negative bacteria. The medical community faces grim reality-general solutions to the treatment of rapidly spreading multidrug-resistant bacteria are neither on the horizon nor anticipated.
新的耐药性挑战不断演变并在全球范围内传播。在这个已经相当成熟的领域，抗菌药物的开发主要受耐药趋势的驱动，重点是开发已知支架的新型类似物，以增强其对特定类别的耐药机制的抵抗力。目前，头孢菌素（带或不带β-内酰胺酶抑制剂）、恶唑烷酮类、糖肽类、喹诺酮类、氨基糖苷类、四环素类和酮内酯类的新型类似物正在进行临床研究。虽然这些新型类似物显示出一定的益处，但它们仅部分解决了多药耐药病原体的临床危机；革兰氏阴性菌尤其如此。医学界面临着严峻的现实——针对迅速传播的多药耐药菌的治疗方法尚无解决方案，也无法预见。
