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新型抗生素在治疗急性细菌性皮肤和皮肤结构感染中的作用。

Role of new antibiotics in the treatment of acute bacterial skin and skin-structure infections.

机构信息

Clinica Malattie Infettive, Ospedale Policlinico San Martino - IRCCS.

Department of Health Sciences, University of Genoa, Genoa, Italy.

出版信息

Curr Opin Infect Dis. 2020 Apr;33(2):110-120. doi: 10.1097/QCO.0000000000000631.

Abstract

PURPOSE OF REVIEW

To summarize the available efficacy and safety data of novel agents for treating acute bacterial skin and skin-structure infections (ABSSSI), focusing on those active against methicillin-resistant Staphylococcus aureus (MRSA).

RECENT FINDINGS

There are now several agents active against MRSA that are approved for the treatment of ABSSSI, including tedizolid, ceftaroline, dalbavancin, telavancin, oritavancin, delafloxacin, and omadacycline. In addition, iclaprim has completed phase-3 randomized clinical trials (RCTs).

SUMMARY

Considering the similar efficacy that arose from direct comparisons in phase-3 RCTs, in order to adopt the best approach for treating ABSSSI on patient-tailored basis, the different safety profiles and formulations of the different available agents should be balanced by taking into account the specific features of each treated patient in terms of baseline comorbidities, related risk of toxicity, need for hospitalization, possibility of early discharge, and expected adherence to outpatient oral therapy.

摘要

目的综述

总结治疗急性细菌性皮肤和皮肤结构感染(ABSSSI)的新型药物的有效性和安全性数据,重点关注那些对耐甲氧西林金黄色葡萄球菌(MRSA)有效的药物。

最新发现

目前有几种针对 MRSA 的药物被批准用于治疗 ABSSSI,包括替加环素、头孢洛林、达巴万星、替拉万星、奥利万星、德拉沙星和奥马环素。此外,依拉环素已完成 3 期随机对照临床试验(RCT)。

总结

考虑到 3 期 RCT 中的直接比较产生的相似疗效,为了根据患者的具体情况选择治疗 ABSSSI 的最佳方法,应根据每个治疗患者的具体特征,平衡不同可用药物的不同安全性概况和制剂,考虑到基线合并症、相关毒性风险、住院需求、早期出院的可能性以及对外用口服治疗的预期依从性。

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