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依拉环素:体外活性、临床疗效和实际应用的全面综述。

Eravacycline: a comprehensive review of in vitro activity, clinical efficacy, and real-world applications.

机构信息

Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.

Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.

出版信息

Expert Rev Anti Infect Ther. 2024 Jun;22(6):387-398. doi: 10.1080/14787210.2024.2351552. Epub 2024 May 8.

Abstract

INTRODUCTION

The escalating threat of multidrug-resistant organisms necessitates constant exploration for novel antimicrobial agents. Eravacycline has emerged as a promising solution due to its unique chemical structure, which enhances potency and expands its spectrum of activity.

AREA COVERED

This review provides a thorough examination of eravacycline, encompassing its in vitro activity against Gram-positive and Gram-negative aerobes, carbapenem-non-susceptible organisms, anaerobes, and other bacterial strains. Additionally, it evaluates evidence from clinical studies to establish its clinical effect and safety.

EXPERT OPINION

Eravacycline, a synthetic fluorocycline, belongs to the tetracyclines class. Similar to other tetracycline, eravacycline exerts its antibacterial action by reversibly binding to the bacterial ribosomal 30S subunit. Eravacycline demonstrates potent in vitro activity against many Gram-positive and Gram-negative aerobes, anaerobes, and multidrug-resistant organisms. Randomized controlled trials and its associated meta-analysis affirm eravacycline's efficacy in treating complicated intra-abdominal infections. Moreover, real-world studies showcase eravacycline's adaptability and effectiveness in diverse clinical conditions, emphasizing its utility beyond labeled indications. Despite common gastrointestinal adverse events, eravacycline maintains an overall favorable safety profile, reinforcing its status as a tolerable antibiotic. However, ongoing research is essential for refining eravacycline's role, exploring combination therapy, and assessing its performance against biofilms, in combating challenging bacterial infections.

摘要

简介

多药耐药菌的威胁不断升级,因此我们需要不断探索新的抗菌药物。依拉环素由于其独特的化学结构,增强了效力并扩大了其活性范围,因此成为一种有前途的解决方案。

涵盖范围

本文全面考察了依拉环素,包括其对革兰氏阳性和革兰氏阴性需氧菌、耐碳青霉烯类药物的病原体、厌氧菌和其他细菌菌株的体外活性。此外,还评估了来自临床研究的证据,以确定其临床效果和安全性。

专家意见

依拉环素是一种合成氟环素,属于四环素类。与其他四环素一样,依拉环素通过可逆地与细菌核糖体 30S 亚基结合发挥其抗菌作用。依拉环素对许多革兰氏阳性和革兰氏阴性需氧菌、厌氧菌和多药耐药菌具有强大的体外活性。随机对照试验及其相关的荟萃分析证实了依拉环素治疗复杂性腹腔内感染的疗效。此外,真实世界的研究展示了依拉环素在各种临床情况下的适应性和有效性,强调了其在标签适应症之外的用途。尽管常见的胃肠道不良反应,但依拉环素总体上具有良好的安全性,这进一步证明了它是一种可耐受的抗生素。然而,为了完善依拉环素的作用、探索联合治疗以及评估其在对抗生物膜方面的表现,以应对具有挑战性的细菌感染,仍需要进行持续的研究。

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