David 发表于 2009-9-29 14:59

万古霉素和达托霉素治疗金葡菌的敏感性关系: 事实和假设

THE LANCET Infectious Diseases
Volume 9, Issue 10, October 2009, Pages 617-624
Review
Susceptibility relationship between vancomycin and daptomycin in Staphylococcus aureus: facts and assumptions
万古霉素和达托霉素治疗金葡菌的敏感性关系: 事实和假设
Pamela A Moise PharmDa, Donald North PharmDa, Judith N Steenbergen PhDa and Dr George Sakoulas MDb, c, d, ,

aCubist Pharmaceuticals, Lexington, MA, USA

bDivision of Infectious Diseases, New York Medical College, Valhalla, NY, USA

cDepartment of Medicine, Sharp Memorial Hospital, San Diego, CA, USA

dDepartment of Pediatrics, University of San Diego School of Medicine, La Jolla, CA, USA


Available online 21 September 2009.

Summary
The decrease in vancomycin treatment efficacy that is accompanying increases in vancomycin minimum inhibitory concentration (MIC) within the susceptible range (so-called MIC creep) has led to the suggestion that vancomycin is losing its potency in treating serious Staphylococcus aureus infections. Understanding the clinical importance of the microbiological effects of glycopeptides on bacterial lipopeptides and lipoglycopeptides will be crucial in treating serious meticillin-resistant S aureus infections. We review the observed effects of reduced glycopeptide susceptibility on the activities of daptomycin in S aureus in vitro and in vivo. Factors associated with loss of susceptibility and ways to reduce the risk of resistance to daptomycin are reviewed, including the importance of prompt mechanical reduction of bacterial inoculum through surgery or through potent or combination antibiotic therapy, as well as optimisation of daptomycin pharmacodynamic exposure.
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