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达托霉素作为封管治疗的一种选择:系统文献回顾。

Daptomycin as an option for lock therapy: a systematic literature review.

机构信息

Department of Internal Medicine, University Hospital of Heraklion, Heraklion, Crete, 71500,Greece.

School of Medicine, University of Crete, Heraklion, Crete, 71500, Greece.

出版信息

Future Microbiol. 2023 Sep;18:917-928. doi: 10.2217/fmb-2023-0059. Epub 2023 Aug 25.

Abstract

To review preclinical and clinical data relevant to daptomycin lock therapy in catheter-related bloodstream infection (CRBSI). Systematic review in PubMed, Scopus and clinical trial registries. Preclinical data demonstrate daptomycin lock solution stability and compatibility with heparin, good biofilm penetration, bactericidal activity against biofilm-embedded bacteria, and high efficacy and in animal catheter infection models. Clinical data remain limited (two case reports and five case series totaling n = 65 CRBSI episodes), albeit promising (successful catheter salvage in about 80% of cases). Despite theoretical advantages of daptomycin, clinical data remain scarce. Comparative studies versus alternative lock solutions are needed, as well as studies to define optimal daptomycin lock regimen (including optimal concentration, dwell time and lock duration).

摘要

回顾与导管相关血流感染(CRBSI)中使用达托霉素封管治疗相关的临床前和临床数据。在 PubMed、Scopus 和临床试验注册中心进行系统评价。临床前数据显示达托霉素封管溶液稳定性和与肝素的相容性、良好的生物膜穿透性、对生物膜包埋细菌的杀菌活性,以及在动物导管感染模型中的高疗效。临床数据仍然有限(两例病例报告和五例病例系列,共 65 例 CRBSI 发作),但有希望(约 80%的病例成功保留导管)。尽管达托霉素具有理论上的优势,但临床数据仍然有限。需要与其他封管溶液进行比较研究,以及研究确定最佳达托霉素封管方案(包括最佳浓度、停留时间和封管时间)。

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