Cooper Rose, Kirketerp-Møller Klaus
Professor of Microbiology, Department of Biomedical Science, Cardiff School of Health Sciences, Cardiff Metropolitan University, Western Avenue, Cardiff, UK.
Orthopaedic Surgeon, Copenhagen Wound Healing Center, Department of Dermatology and Wounds, Bispebjerg University Hospital, Bispebjerg Bakke 23, DK-2400 Copenhagen NV.
J Wound Care. 2018 Jun 2;27(6):355-377. doi: 10.12968/jowc.2018.27.6.355.
Control of wound infection today relies largely on antibiotics, but the continual emergence of antibiotic-resistant microorganisms threatens a return to the pre-antibiotic era when physicians used antiseptics to prevent and manage infection. Some of those antiseptics are still used today, and others have become available. A diverse variety of non-antibiotic antimicrobial interventions are found on modern formularies. Unlike the mode of action of antibiotics, which affect specific cellular target sites of pathogens, many non-antibiotic antimicrobials affect multiple cellular target sites in a non-specific way. Although this reduces the likelihood of selecting for resistant strains of microorganisms, some have emerged and cross-resistance between antibiotics and antiseptics has been detected. With the prospect of a post-antibiotic era looming, ways to maintain and extend our antimicrobial armamentarium must be found. In this narrative review, current and emerging non-antibiotic antimicrobial strategies will be considered and the need for antimicrobial stewardship in wound care will be explained.
如今，伤口感染的控制在很大程度上依赖于抗生素，但抗生素耐药微生物的不断出现，有可能使我们重回抗生素出现之前的时代，那时医生使用防腐剂来预防和处理感染。其中一些防腐剂至今仍在使用，还有一些也已问世。现代药品配方中有各种各样的非抗生素抗菌干预措施。与抗生素作用于病原体特定细胞靶点的作用方式不同，许多非抗生素抗菌剂以非特异性方式影响多个细胞靶点。虽然这降低了选择出微生物耐药菌株的可能性，但仍出现了一些耐药菌株，并且已检测到抗生素和防腐剂之间的交叉耐药性。随着后抗生素时代的前景逐渐显现，必须找到维持和扩充我们抗菌药物库的方法。在这篇叙述性综述中，我们将探讨当前和新出现的非抗生素抗菌策略，并解释伤口护理中抗菌管理的必要性。
