Department of Pediatrics, Federal University of Bahia School of Medicine, Salvador, Brazil.
Expert Opin Pharmacother. 2021 Oct;22(15):1975-1982. doi: 10.1080/14656566.2021.1957098. Epub 2021 Aug 4.
Community-acquired pneumonia (CAP) is a leading cause of morbidity and mortality in adults. Bacterial pathogens are recognized to be frequent causative agents, which makes antibacterial treatment crucial for the evolution of these patients. There are several antimicrobial options available in daily practice. However, bacterial resistance is a problem. The chemical, pharmacokinetic, pharmacodynamics, and safety characteristics of delafloxacin, a fluoroquinolone, are discussed. The data from one phase 3 clinical trial evaluating the use of delafloxacin in adults with community-acquired pneumonia is also discussed, along with findings from other meaningful studies. data have shown that delafloxacin has broad spectrum activity. Results from phase 2 and phase 3 studies have demonstrated that delafloxacin use is safe. International guidelines have recommended respiratory fluoroquinolones as second option for non-severe cases and must be considered in very severe patients not improving to a betalactam/macrolide combination. Delafloxacin was compared to moxifloxacin in the phase 3 community-acquired pneumonia trial. Serious and life-long adverse events due to fluoroquinolones use have been recently reported. Delafloxacin may possibly replace currently available fluoroquinolones, particularly in the treatment of resistant pathogens, such as ciprofloxacin-resistant isolates when other drugs are inefficient.
社区获得性肺炎(CAP)是导致成年人发病率和死亡率的主要原因。细菌病原体被认为是常见的致病因素,这使得抗菌治疗对这些患者的病情发展至关重要。在日常实践中有多种抗菌药物可供选择。然而,细菌耐药性是一个问题。本文讨论了氟喹诺酮类药物德拉沙星的化学、药代动力学、药效学和安全性特征。还讨论了评估德拉沙星在成人社区获得性肺炎中的应用的一项 3 期临床试验的数据,以及其他有意义的研究结果。数据表明,德拉沙星具有广谱活性。2 期和 3 期研究的结果表明,德拉沙星的使用是安全的。国际指南建议将呼吸氟喹诺酮类药物作为非重症病例的二线选择,并且必须在病情严重且对β内酰胺/大环内酯类联合治疗无改善的患者中考虑使用。在 3 期社区获得性肺炎试验中,德拉沙星与莫西沙星进行了比较。最近有报道称,由于使用氟喹诺酮类药物而导致严重且终身的不良事件。德拉沙星可能会取代目前可用的氟喹诺酮类药物,特别是在治疗耐药病原体方面,例如当其他药物无效时,对环丙沙星耐药的分离株。