Department of Pharmacy, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324 Jingwu Road, Huaiyin District, Jinan 250021, China.
Medical Department, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324 Jingwu Road, Huaiyin District, Jinan 250021, China.
J Glob Antimicrob Resist. 2021 Jun;25:315-322. doi: 10.1016/j.jgar.2021.04.006. Epub 2021 May 4.
Tigecycline, a new first-in-class glycylcycline antibiotic, has shown promising efficacy against a broad range of micro-organisms. It is widely prescribed for various infections, with most prescriptions being considered for off-label use. However, only a few years after its approval by the US Food and Drug Administration (FDA), tigecycline is suspected of increasing all-cause mortality. Some clinicians have suggested such unfavourable outcomes correlate with inadequate drug exposure at the infection site. The pharmacokinetic/pharmacodynamic (PK/PD) profile of a drug plays an important role in predicting its antibiotic effect, which for tigecycline is determined as the ratio of area under the concentration-time curve (AUC) to minimum inhibitory concentration (MIC). In this study, PK/PD targets based on infection sites, bacterial isolates and patient populations are discussed. Generally, a higher dosage of tigecycline for the treatment of serious infections has been recommended in previous reports. However, the latest finding of tigecycline's atypical protein binding property requires consideration when recommending further use. In addition, combination therapy with other antibiotics provides another option by potentially lowering the MICs of multidrug-resistant bacteria.
替加环素是一种新型的甘氨酰环素类抗生素，对广泛的微生物具有良好的疗效。它被广泛用于各种感染的治疗，大多数处方被认为是超适应证使用。然而，在替加环素获得美国食品和药物管理局（FDA）批准后的短短几年内，它就被怀疑会增加全因死亡率。一些临床医生认为，这种不良结局与感染部位药物暴露不足有关。药物的药代动力学/药效学（PK/PD）特征在预测其抗生素效果方面起着重要作用，替加环素的效果由浓度-时间曲线下面积（AUC）与最小抑菌浓度（MIC）的比值来确定。在本研究中，讨论了基于感染部位、细菌分离株和患者人群的 PK/PD 目标。一般来说，之前的报告建议对严重感染采用更高剂量的替加环素治疗。然而，替加环素的非典型蛋白结合特性的最新发现需要在进一步推荐使用时加以考虑。此外，联合使用其他抗生素可能通过降低多重耐药菌的 MIC 值提供另一种选择。
