Nursing Department, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Department of Internal Medicine, Division of Infectious Diseases and Tropical Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
J Chemother. 2022 May;34(3):166-172. doi: 10.1080/1120009X.2021.2005755. Epub 2021 Nov 25.
Several antimicrobial combination therapies are used to treat multiple drug resistant (MDR) and extensively drug resistant (XDR) infections. A novel antibiotic, eravacycline, shows a higher potency than tigecycline. The efficacies of eravacycline-based therapies have not yet been evaluated. We demonstrated the effectiveness of eravacycline- and tigecycline-based combination therapies in XDR and especially tigecycline resistant . Thirteen eligible isolates were selected from 642 non-duplicate blood isolates from four medical centres in 2010-2014. Tigecycline/imipenem and eravacycline/imipenem combinations were simultaneously effective against some isolates with fractional inhibitory concentration index of 0.5. In contrast, eravacycline- and tigecycline-based combination therapies provided no additional benefits in mouse survival compared to those for monotherapy. In summary, colistin is still the final resort for XDR- treatment according to the sensitivities. Owning to rapid development of resistance in novel antibiotics are urgently needed.
多种抗菌联合疗法用于治疗多重耐药（MDR）和广泛耐药（XDR）感染。一种新型抗生素依拉环素的效力优于替加环素。基于依拉环素的治疗方法的疗效尚未得到评估。我们证实了依拉环素和替加环素联合治疗在 XDR 和特别是替加环素耐药中的有效性。从 2010 年至 2014 年，在四个医疗中心的 642 份非重复血培养物中，选择了 13 株符合条件的分离株。替加环素/亚胺培南和依拉环素/亚胺培南联合治疗对一些分离株具有相同的疗效，其部分抑菌浓度指数为 0.5。相比之下，与单药治疗相比，依拉环素和替加环素联合治疗在小鼠存活方面并没有提供额外的益处。综上所述，根据药敏试验，多粘菌素仍然是治疗 XDR 的最后手段。需要迫切开发新型抗生素以应对耐药性的快速发展。
