Herrera-Hidalgo Laura, Fernández-Rubio Beatriz, Luque-Márquez Rafael, López-Cortés Luis E, Gil-Navarro Maria V, de Alarcón Arístides
Unidad de Gestión Clínica de Farmacia, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío, 41013 Seville, Spain.
Unidad Clínica de Enfermedades Infecciosas, Microbiología y Parasitología (UCEIMP) Grupo de Resistencias Bacterianas y Antimicrobianos (CIBERINFEC), Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, 41013 Seville, Spain.
Antibiotics (Basel). 2023 Apr 4;12(4):704. doi: 10.3390/antibiotics12040704.
Today, is one of the main causes of infective endocarditis in the world, generally affecting an elderly and fragile population, with a high mortality rate. Enterococci are partially resistant to many commonly used antimicrobial agents such as penicillin and ampicillin, as well as high-level resistance to most cephalosporins and sometimes carbapenems, because of low-affinity penicillin-binding proteins, that lead to an unacceptable number of therapeutic failures with monotherapy. For many years, the synergistic combination of penicillins and aminoglycosides has been the cornerstone of treatment, but the emergence of strains with high resistance to aminoglycosides led to the search for new alternatives, like dual beta-lactam therapy. The development of multi-drug resistant strains of is a matter of considerable concern due to its probable spread to and have necessitated the search of new guidelines with the combination of daptomycin, fosfomycin or tigecycline. Some of them have scarce clinical experience and others are still under investigation and will be analyzed in this review. In addition, the need for prolonged treatment (6-8 weeks) to avoid relapses has forced to the consideration of other viable options as outpatient parenteral strategies, long-acting administrations with the new lipoglycopeptides (dalbavancin or oritavancin), and sequential oral treatments, which will also be discussed.
如今，[原文此处缺失相关内容]是全球感染性心内膜炎的主要病因之一，通常影响老年及体弱人群，死亡率较高。肠球菌对许多常用抗菌药物如青霉素和氨苄西林部分耐药，对大多数头孢菌素有时甚至对碳青霉烯类药物也有高水平耐药，这是因为青霉素结合蛋白亲和力低，导致单药治疗失败率高得令人无法接受。多年来，青霉素和氨基糖苷类药物的协同联合一直是治疗的基石，但对氨基糖苷类高度耐药菌株的出现促使人们寻找新的替代方案，如双联β-内酰胺治疗。[原文此处缺失相关内容]多药耐药菌株的出现令人相当担忧，因为其可能传播至[原文此处缺失相关内容]，因此有必要寻找新的指南，联合使用达托霉素、磷霉素或替加环素。其中一些药物临床经验稀缺，其他药物仍在研究中，本文将对其进行分析。此外，为避免复发需要延长治疗时间（6 - 8周），这促使人们考虑其他可行方案，如门诊胃肠外给药策略、新型脂糖肽类（达巴万星或奥利万星）的长效给药以及序贯口服治疗，本文也将对此进行讨论。
