Moellering R C
Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215, USA.
Clin Infect Dis. 1998 Aug;27 Suppl 1:S135-40; discussion S141-2. doi: 10.1086/514902.
It is clear that emergence of resistant bacterial strains will continue to be a problem as long as clinicians use the currently available antimicrobial agents. Past and current policies for dealing with resistance have, at best, been only partially effective. Thus, novel approaches to the problem of antimicrobial resistance are badly needed. Development of novel "classic" antimicrobial agents, chemical modification of currently known agents to overcome resistance, and the development of potentiators of known antimicrobials represent three areas that have been partially exploited in the past and continue to represent fertile fields for additional investigation. In addition, a number of investigators are working to develop inhibitors of new bacterial targets and to develop inhibitors of genes relating to virulence or pathogenesis. Although the deployment of antisense nucleotides as antimicrobial agents is theoretically appealing, to date, it has not been possible to develop any of these agents for clinical use.
很明显，只要临床医生使用目前可用的抗菌药物，耐药菌株的出现将继续是一个问题。过去和当前应对耐药性的政策充其量只是部分有效。因此，迫切需要解决抗菌药物耐药性问题的新方法。开发新型“经典”抗菌药物、对现有药物进行化学修饰以克服耐药性，以及开发已知抗菌药物的增效剂，这三个领域在过去已得到部分利用，并且仍然是有待进一步研究的沃土。此外，许多研究人员正在致力于开发针对新细菌靶点的抑制剂，以及开发与毒力或发病机制相关基因的抑制剂。虽然将反义核苷酸用作抗菌药物在理论上很有吸引力，但迄今为止，还无法将这些药物中的任何一种开发用于临床。
