Rodvold K A
Department of Pharmacy, College of Pharmacy, University of Illinois, Chicago 60612.
Pharmacotherapy. 1988;8(6 Pt 2):14S-18S.
Most institutions are experiencing increased numbers of methicillin-resistant S. epidermidis infections. Currently, vancomycin is the only antibiotic that provides reliable bactericidal activity against this microorganism, including methicillin-resistant strains. Vancomycin is the treatment of choice for infections caused by methicillin-resistant staphylococci and for serious gram-positive infections in penicillin-allergic patients. With the emergence of more numerous and more serious gram-positive infections, this agent either alone or in combination with other antibiotics will clearly assume greater importance in the management of gram-positive infections, independent of host allergy or bacterial resistance. It is assuming a pivotal role in the treatment of gram-positive infections of central nervous system or dialysis shunts, endocarditis, meningitis, and septicemia. Except in patients with confirmed allergy to a beta-lactam antibiotic, vancomycin is not indicated for routine surgical prophylaxis. The current upsurge in methicillin-resistant staphylococcal infections as a complication of implant surgery may necessitate its use as a prophylactic agent, however.
大多数医疗机构中耐甲氧西林表皮葡萄球菌感染的病例数都在增加。目前，万古霉素是唯一一种对该微生物（包括耐甲氧西林菌株）具有可靠杀菌活性的抗生素。万古霉素是耐甲氧西林葡萄球菌引起的感染以及青霉素过敏患者严重革兰氏阳性菌感染的首选治疗药物。随着革兰氏阳性菌感染越来越多且越来越严重，这种药物单独使用或与其他抗生素联合使用，在革兰氏阳性菌感染的治疗中显然将变得更加重要，而与宿主过敏或细菌耐药性无关。它在中枢神经系统或透析分流管的革兰氏阳性菌感染、心内膜炎、脑膜炎和败血症的治疗中发挥着关键作用。除了已证实对β-内酰胺类抗生素过敏的患者外，万古霉素不用于常规手术预防。然而，作为植入手术并发症的耐甲氧西林葡萄球菌感染目前呈上升趋势，这可能使其有必要用作预防药物。
