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抗菌药物治疗儿童金黄色葡萄球菌和耐甲氧西林金黄色葡萄球菌严重感染的专家建议

Antimicrobial prescribing for treatment of serious infections caused by Staphylococcus aureus and methicillin-resistant Staphylococcus aureus in pediatrics: an expert review.

机构信息

Antiviral Pharmacology Laboratory, University of Nebraska Medical Center (UNMC) Center for Drug Discovery, UNMC, Omaha, NE, USA.

University of Nebraska Medical Center, College of Pharmacy, Omaha, NE, USA.

出版信息

Expert Rev Anti Infect Ther. 2021 Sep;19(9):1107-1116. doi: 10.1080/14787210.2021.1886923. Epub 2021 Feb 21.

Abstract

: , including methicillin-resistant (MRSA), remains a significant pathogen in children. Despite evidence of decreasing prevalence, MRSA bacteremia has been closely associated with complications, including certain infections (i.e. musculoskeletal and endovascular) linked to increased treatment failures.: This expert review summarized recent published literature on the role of treatment, dosing and administration of antibiotics used to combat serious infections in children. The pertinent antibiotics presented were vancomycin, oxazolidinones, semi-synthetic glycopeptides, daptomycin, tigecycline, novel cephalosporins, fosfomycin and lefamulin. Vancomycin has been the most commonly used antibiotic in empiric therapy for serious MRSA infection, with new key recommendations emphasizing a different approach to dosing and therapeutic monitoring. For other antibiotics, data remain limited or clinical trials are underway.: MRSA remains a significant pathogen in the pediatric population. As numerous therapeutic agents are available, many agents have limited data on usage in pediatric patients. Future studies require pharmacokinetic, safety and efficacy studies in pediatric patients to ensure appropriate therapeutic treatment and outcomes. Phage therapy has been used to treat deep-seated MRSA infections and is an emerging investigational treatment option.

摘要

耐甲氧西林金黄色葡萄球菌(MRSA)等病原体依然是儿童感染的重要致病因素。尽管已有证据表明其流行率呈下降趋势,但耐甲氧西林金黄色葡萄球菌菌血症与多种并发症密切相关,包括某些感染(如肌肉骨骼和血管内),这些感染与治疗失败率增加有关。

本专家综述总结了近期发表的关于治疗、剂量和管理抗生素用于治疗儿童严重感染的文献。本文介绍了万古霉素、恶唑烷酮类、半合成糖肽类、达托霉素、替加环素、新型头孢菌素、磷霉素和利福霉素。万古霉素一直是严重耐甲氧西林金黄色葡萄球菌感染经验性治疗中最常用的抗生素,新的关键建议强调了不同的剂量和治疗监测方法。对于其他抗生素,数据仍然有限,或正在进行临床试验。

耐甲氧西林金黄色葡萄球菌依然是儿科人群中的重要病原体。由于有许多治疗药物可用,许多药物在儿科患者中的使用数据有限。未来的研究需要在儿科患者中进行药代动力学、安全性和疗效研究,以确保进行适当的治疗和获得良好的治疗效果。噬菌体治疗已被用于治疗深部耐甲氧西林金黄色葡萄球菌感染,是一种新兴的治疗选择。

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