de Lastours V, Fantin B
Service de médecine interne, hôpital Beaujon, AP-HP, 100, boulevard du Général-Leclerc, 92100 Clichy, France; Équipe d'accueil 3964 « emergence de la résistance aux antibiotiques in vivo », faculté de médecine Xavier-Bichat, université Paris Diderot, 75018 Paris, France.
Service de médecine interne, hôpital Beaujon, AP-HP, 100, boulevard du Général-Leclerc, 92100 Clichy, France; Équipe d'accueil 3964 « emergence de la résistance aux antibiotiques in vivo », faculté de médecine Xavier-Bichat, université Paris Diderot, 75018 Paris, France.
Rev Med Interne. 2014 Sep;35(9):601-8. doi: 10.1016/j.revmed.2014.05.005. Epub 2014 Jun 6.
Because of their important qualities, fluoroquinolones are amongst the most prescribed antibiotics in the world. The corollary of this success is the rapid increase in resistance to fluoroquinolones, responsible for treatment failures. Moreover, fluoroquinolone-resistance is often accompanied by resistance to other classes of antibiotics. Currently, significant levels of resistance are found both in hospitals and in community settings, severely limiting possibilities for empirical use of fluoroquinolones. A major mechanism explaining the rapid emergence of resistance to fluoroquinolones is their specific impact on human microbiota and the selection of resistant strains in the microbiota, which seems to be an unavoidable ecological side effect. In order to preserve the efficiency of this important class of antibiotics, limiting their use and respecting good practice recommendations are essential.
由于其重要特性,氟喹诺酮类药物是全球处方量最大的抗生素之一。这种成功带来的必然结果是对氟喹诺酮类药物的耐药性迅速增加,导致治疗失败。此外,氟喹诺酮耐药性常常伴随着对其他类抗生素的耐药性。目前,在医院和社区环境中均发现了显著水平的耐药性,这严重限制了氟喹诺酮类药物经验性使用的可能性。解释氟喹诺酮类药物耐药性迅速出现的一个主要机制是它们对人体微生物群的特定影响以及微生物群中耐药菌株的选择,这似乎是一种不可避免的生态副作用。为了保持这类重要抗生素的疗效,限制其使用并遵循良好实践建议至关重要。