Burgos Rodrigo M, Rodvold Keith A
Department of Pharmacy Practice, University of Illinois at Chicago College of Pharmacy, Chicago, IL, USA.
Department of Medicine, University of Illinois at Chicago College of Medicine, Chicago, IL, USA.
Infect Drug Resist. 2019 Jul 2;12:1895-1915. doi: 10.2147/IDR.S171352. eCollection 2019.
Tetracyclines have come a long way since they became available almost seven decades ago, with numerous enhancements allowing new agents to overcome bacterial mechanisms of resistance. However, these enhancements come with toxicities and pharmacokinetic disadvantages such as the gastrointestinal side-effects and poor oral bioavailability seen with the glycylcylcines. Omadacycline, a new and improved tetracycline, has demonstrated a broad spectrum of in vitro activity, has oral and intravenous formulations, improved safety compared to glycylcyclines, as well as clinical efficacy and safety for two types of infections: acute bacterial skin and skin structure infections and community-acquired bacterial pneumonia. This review will summarize salient points about its pharmacologic properties, available clinical efficacy, and safety data and omadacycline's place in therapy.
自近七十年前四环素问世以来,它们已经取得了长足的发展,经过多次改进,新的制剂能够克服细菌的耐药机制。然而,这些改进也带来了毒性和药代动力学方面的缺点,比如甘氨酰环素类药物出现的胃肠道副作用和口服生物利用度差等问题。奥马环素是一种经过改良的新型四环素,已显示出广泛的体外活性,有口服和静脉注射剂型,与甘氨酰环素类药物相比安全性有所提高,并且对两种感染类型具有临床疗效和安全性:急性细菌性皮肤及皮肤结构感染和社区获得性细菌性肺炎。本综述将总结其药理特性、现有临床疗效、安全性数据以及奥马环素在治疗中的地位等要点。