Infectious Diseases Clinic, Department of Health Sciences, University of Genoa, Genoa and Hospital Policlinico San Martino - IRCCS , Genoa , Italy.
Infectious Diseases Clinic, Department of Medicine University of Udine, Sanitaria Universitaria Integrata di Udine , Udine , Italy.
Expert Opin Emerg Drugs. 2019 Sep;24(3):191-204. doi: 10.1080/14728214.2019.1677607.
: In clinical practice, methicillin-resistant (MRSA) represents a major threat and has been associated with high rates of inadequate antibiotic treatment and significant increases in morbidity, mortality, and overall healthcare costs. The association between the prescription of an inappropriate or delayed antibiotic and impaired clinical outcomes has been widely described. : To address the threat of MRSA, many new therapeutic options with a peculiar activity against MRSA have been recently developed and approved. New agents are characterized by specific issues in terms of spectrum of activity, pharmacokinetics, risk of drug-drug interactions, and toxicity, with potential advantages that should be considered in everyday clinical practice. : The most attractive characteristic of new drugs is represented by the broad spectrum of activity against multidrug-resistant pathogens; moreover, new compounds in most cases are characterized by favorable toxicity profiles compared with old drugs currently used in clinical practice. Some of the new antimicrobials will be also available as oral formulations, with the potential for oral switch, even in infections due to resistant pathogens. In particular conditions/populations (e.g. liver failure, renal disease, pregnancy, diabetic, children, and elderly), novel antibiotics with reduced toxicity could be an important option, including after hospital discharge.
: 在临床实践中，耐甲氧西林金黄色葡萄球菌（MRSA）是一个主要威胁，它与抗生素治疗不足的高比率以及发病率、死亡率和整体医疗成本的显著增加有关。抗生素使用不当或延迟与临床结局恶化之间的关联已被广泛描述。 : 为了应对 MRSA 的威胁，最近已经开发并批准了许多具有针对 MRSA 的特殊活性的新型治疗选择。新的治疗药物在活性谱、药代动力学、药物相互作用风险和毒性方面具有特定问题，具有在日常临床实践中应考虑的潜在优势。 : 新药最吸引人的特点是对多种耐药病原体具有广泛的活性；此外，与目前在临床实践中使用的旧药物相比，新化合物在大多数情况下具有良好的毒性特征。一些新的抗菌药物也将作为口服制剂提供，即使在针对耐药病原体的感染中，也有可能进行口服转换。在特定条件/人群（例如肝衰竭、肾功能不全、妊娠、糖尿病、儿童和老年人）中，毒性降低的新型抗生素可能是一个重要的选择，包括出院后。
