CNRS-IRD, UMR 6236, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, Faculté de Médecine et de Pharmacie, Aix-Marseille Université, 27, Boulevard Jean-Moulin, 13385 Marseille Cedex 05, France.
Expert Rev Anti Infect Ther. 2012 Aug;10(8):917-34. doi: 10.1586/eri.12.78.
The emergence of multidrug-resistant Gram-negative bacteria that cause nosocomial infections is a growing problem worldwide. Colistin was first introduced in 1952 and was used until the early 1980s for the treatment of infections caused by Gram-negative bacilli. In vitro, colistin has demonstrated excellent activity against various Gram-negative rod-shaped bacteria, including multidrug-resistant Pseudomonas aeruginosa, Acinetobacter baumannii and Klebsiella pneumoniae. Recent clinical findings regarding colistin activity, pharmacokinetic properties, clinical uses, emerging resistance, toxicities and combination therapy have been reviewed. Recent approaches to the use of colistin in combination with other antibiotics hold promise for increased antibacterial efficacy. It is probable that colistin will be the 'last-line' therapeutic drug against multidrug-resistant Gram-negative pathogens in the 21st century.
多药耐药革兰氏阴性菌引起的医院感染的出现是一个全球性的日益严重的问题。黏菌素于 1952 年首次被引入，并在 20 世纪 80 年代初之前用于治疗革兰氏阴性杆菌引起的感染。在体外，黏菌素对各种革兰氏阴性棒状细菌表现出极好的活性，包括多药耐药铜绿假单胞菌、鲍曼不动杆菌和肺炎克雷伯菌。最近对黏菌素活性、药代动力学特性、临床应用、耐药性的出现、毒性和联合治疗的临床研究进行了综述。最近采用黏菌素与其他抗生素联合使用的方法有望提高抗菌疗效。黏菌素可能成为 21 世纪治疗多药耐药革兰氏阴性病原体的“最后一线”治疗药物。
