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目前在心脏手术和术后重症监护中使用达托霉素的情况。

Current use of daptomycin in cardiac surgery and postoperative intensive care.

机构信息

Department of Thoracic and Cardiovascular Surgery, Johann Wolfgang Goethe University, Theodor Stern Kai 7, Frankfurt, Germany.

出版信息

Expert Rev Anti Infect Ther. 2013 Mar;11(3):309-20. doi: 10.1586/eri.13.3.

Abstract

Infections due to multidrug-resistant pathogens have an increasing impact on patients undergoing cardiac surgery. Preoperative infections, such as endocarditis, and postoperative infections, including wound and device infection, influence patient outcomes. Special interest needs to be taken in patients admitted to cardiac surgical intensive care units, as these patients are at high risk for infections, particularly nosocomial pneumonia, catheter-related and wound infections. The increasing numbers of infections due to Gram-positive multidrug-resistant pathogens underline the necessity for newer antibiotics with bactericidal effects and a more favorable profile of side effects. Daptomycin, a lipopeptide antimicrobial agent with bactericide activity against Gram-positive organisms, has been successfully used in the treatment of complicated infections due to Gram-positive multidrug-resistant pathogens, especially regarding endocarditis, wound infections, device and catheter-related infections in intensive care units. In this review, the authors will summarize therapeutic potential of daptomycin in cardiac surgery and postoperative intensive care.

摘要

由于耐多药病原体引起的感染对接受心脏手术的患者的影响日益增加。术前感染,如心内膜炎,和术后感染,包括伤口和器械感染,影响患者的结局。需要特别关注入住心脏外科重症监护病房的患者,因为这些患者感染的风险很高,特别是医院获得性肺炎、导管相关和伤口感染。由于革兰氏阳性耐多药病原体引起的感染数量不断增加,强调了需要具有杀菌作用和更有利的副作用特征的新型抗生素。达托霉素是一种脂肽类抗菌药物,对革兰氏阳性菌具有杀菌活性,已成功用于治疗革兰氏阳性耐多药病原体引起的复杂感染,特别是在心内膜炎、伤口感染、重症监护病房的器械和导管相关感染方面。在这篇综述中,作者将总结达托霉素在心外科手术和术后重症监护中的治疗潜力。

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