Biomedicine Discovery Institute, Infection & Immunity Program and Department of Microbiology, Monash University, Clayton Campus, Melbourne, VIC, Australia.
Adv Exp Med Biol. 2019;1145:1-8. doi: 10.1007/978-3-030-16373-0_1.
Antibiotic resistance has become the most significant threat to human health across the globe. Polymyxins are often used as the only available therapeutic option against Gram-negative 'superbugs', namely Acinetobacter baumannii, Pseudomonas aeruginosa and Klebsiella pneumoniae. The limited pharmacological and clinical knowledge on the polymyxins in the old literature substantially limited optimizing their clinical use. The current chapter provides a general introduction to this first-ever polymyxin book which comprehensively reviews the significant progress over the last two decades in the chemistry, microbiology, pharmacology, clinical use and drug discovery of polymyxins. In particular, recent pharmacological results have led to the first scientifically-based dosing recommendations and facilitated the discovery of new-generation polymyxins. Future challenges in polymyxin research are highlighted, aiming at improving the clinical utility of this last-line defence.
抗生素耐药性已成为全球范围内对人类健康的最大威胁。多黏菌素通常被用作针对革兰氏阴性“超级细菌”（即鲍曼不动杆菌、铜绿假单胞菌和肺炎克雷伯菌）的唯一有效治疗选择。旧文献中关于多黏菌素的药理学和临床知识有限，极大地限制了其临床应用的优化。本章提供了有史以来第一本多黏菌素书籍的概述，全面回顾了过去二十年在多黏菌素的化学、微生物学、药理学、临床应用和药物发现方面的重要进展。特别是，最近的药理学研究结果导致了首次基于科学的剂量建议，并促进了新一代多黏菌素的发现。突出了多黏菌素研究中的未来挑战，旨在提高这种最后防线药物的临床实用性。
