Williams Phoebe Cm
Department of Infectious Diseases and Immunology, Sydney Children's Hospital, Sydney, New South Wales, Australia.
Nuffield Department of Medicine, The University of Oxford, Headington, UK.
J Paediatr Child Health. 2020 Jun;56(6):864-872. doi: 10.1111/jpc.14883. Epub 2020 Apr 15.
In an era of increasing antimicrobial resistance, there are limited treatment options available to treat multidrug-resistant organisms in paediatric patients. Fosfomycin is an antibiotic defined as 'critically important' by The World Health Organization due to its potential efficacy against multidrug-resistant bacteria and is increasingly cited in the international literature as a promising antimicrobial for combating sepsis in an era of increasing antimicrobial resistance. With broad-spectrum cover that includes both Gram-positive and Gram-negative organisms and both parenteral and oral formulations available, fosfomycin provides a promising treatment option for paediatric patients. This review summarises fosfomycin's spectrum of activity, published efficacy in paediatric patients, safety considerations and pharmacokinetic data, as well as identifying current clinical trials delineating pharmacokinetic parameters and safety parameters in neonatal sepsis which will provide further information regarding the use of fosfomycin in neonatal and paediatric infections. Limitations regarding the current standards for fosfomycin susceptibility definitions, variations in dosing regimens and the potential mechanisms for resistance are also discussed.
在抗菌药物耐药性不断增加的时代，治疗儿科患者多重耐药菌的可用治疗选择有限。磷霉素是一种被世界卫生组织定义为“至关重要”的抗生素，因其对多重耐药菌具有潜在疗效，并且在国际文献中越来越多地被引述为在抗菌药物耐药性不断增加的时代对抗败血症的一种有前景的抗菌药物。磷霉素具有包括革兰氏阳性菌和革兰氏阴性菌的广谱覆盖范围，且有肠胃外和口服制剂，为儿科患者提供了一种有前景的治疗选择。本综述总结了磷霉素的活性谱、在儿科患者中的已发表疗效、安全性考量和药代动力学数据，以及确定当前正在进行的描绘新生儿败血症中药代动力学参数和安全性参数的临床试验，这将提供有关磷霉素在新生儿和儿科感染中使用的更多信息。还讨论了磷霉素敏感性定义的当前标准的局限性、给药方案的差异以及耐药性的潜在机制。
