Brennan-Krohn Thea, Kirby James E
Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, 3 Blackfan Circle - CLS0624, Boston, MA 02115, USA; Division of Infectious Diseases, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue - YA309, Boston, MA 02215, USA.
Clin Lab Med. 2019 Sep;39(3):345-358. doi: 10.1016/j.cll.2019.04.002. Epub 2019 Jun 12.
Antibacterial combinations have long been used to accomplish a variety of therapeutic goals, including prevention of resistance and enhanced antimicrobial activity. In vitro synergy testing methods, including the checkerboard array, the time-kill study, diffusion assays, and pharmacokinetic/pharmacodynamic models, are used commonly in the research setting, but are not routinely performed in the clinical microbiology laboratory because of test complexity and uncertainty about their predictive value for patient outcomes. Optimized synergy testing techniques and better data on the relationship between in vitro results and clinical outcomes are needed to guide the rational use of antimicrobial combinations in the multidrug resistance era.
抗菌联合用药长期以来一直被用于实现各种治疗目标，包括预防耐药性和增强抗菌活性。体外协同试验方法，包括棋盘法、时间杀菌研究、扩散试验和药代动力学/药效学模型，在研究环境中普遍使用，但由于试验复杂性以及它们对患者预后预测价值的不确定性，在临床微生物学实验室中并非常规进行。在多重耐药时代，需要优化的协同试验技术以及关于体外结果与临床结局之间关系的更好数据，以指导抗菌联合用药的合理使用。
