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奈诺沙星治疗常见感染的潜在作用。

The potential role of nemonoxacin for treatment of common infections.

作者信息

Huang Chung-Hao, Lai Chung-Chih, Chen Yen-Hsu, Hsueh Po-Ren

机构信息

Kaohsiung Medical University, Kaohsiung Medical University Hospital, Division of Infectious Diseases, Department of Internal Medicine , Kaohsiung , Taiwan

出版信息

Expert Opin Pharmacother. 2015 Feb;16(2):263-70. doi: 10.1517/14656566.2015.978288. Epub 2014 Dec 22.

Abstract

INTRODUCTION

Nemonoxacin , a novel non-fluorinated quinolone, exhibits potent activity against Gram-positive bacteria, including MRSA and fluoroquinolone-resistant MRSA, Gram-negative and atypical pathogens. This agent also has a reduced propensity for resistance development in many kinds of pathogens.

AREAS COVERED

This article reviews currently available clinical and in vitro data that support the potential role of nemonoxacin for the treatment of common infectious diseases, including community-acquired pneumonia (CAP), Clostridium difficile infections (CDIs), acute bacterial skin and skin structure infections (ABSSSIs) and sexually transmitted diseases (STDs). One recent Phase II trial comparing either 500 mg or 750 mg oral nemonoxacin with 500 mg oral levofloxacin for mild to moderate CAP demonstrated that nemonoxacin had comparable clinical success with levofloxacin. Nemonoxacin showed lower MICs against clinical C. difficile isolates than commercially available fluoroquinolones, making it a potential therapeutic agent if novel formulations are developed to maintain a higher concentration in the human gut. For STDs, nemonoxacin also showed good activity against some common pathogens, such as Chlamydia trachomatis and Neisseria gonorrhoeae.

EXPERT OPINION

Although in vitro studies have shown promising results regarding the susceptibility to nemonoxacin of common pathogens causing CDIs, ABSSSIs and STDs, further clinical trials are needed to prove its efficacy.

摘要

引言

奈诺沙星是一种新型非氟喹诺酮类药物,对革兰氏阳性菌具有强大活性,包括耐甲氧西林金黄色葡萄球菌(MRSA)和耐氟喹诺酮类MRSA、革兰氏阴性菌及非典型病原体。该药物在多种病原体中产生耐药性的倾向也较低。

涵盖领域

本文综述了目前可得的临床和体外数据,这些数据支持奈诺沙星在治疗常见传染病中的潜在作用,包括社区获得性肺炎(CAP)、艰难梭菌感染(CDI)、急性细菌性皮肤及皮肤结构感染(ABSSSI)和性传播疾病(STD)。最近一项II期试验比较了500毫克或750毫克口服奈诺沙星与500毫克口服左氧氟沙星治疗轻度至中度CAP的效果,结果表明奈诺沙星与左氧氟沙星在临床疗效上相当。奈诺沙星对临床分离的艰难梭菌的最低抑菌浓度低于市售氟喹诺酮类药物,如果开发出能在人体肠道中维持较高浓度的新剂型,它将成为一种潜在的治疗药物。对于性传播疾病,奈诺沙星对一些常见病原体,如沙眼衣原体和淋病奈瑟菌也显示出良好活性。

专家意见

尽管体外研究已显示奈诺沙星对引起CDI、ABSSSI和STD的常见病原体的敏感性有令人期待的结果,但仍需进一步的临床试验来证明其疗效。

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