治疗困难 Clostridioides 感染的药物:分子和微生物
1Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
Expert review of gastroenterology & hepatology
|August 22, 2023
概括
克洛斯特里迪奥伊德困难感染 (CDI) 管理已经发展,在最初的发作中偏好口服万科米辛或菲达克索米辛. 基于微生物组的新疗法和单克隆抗体有助于预防复发性CDI.
科学领域:
- 传染性疾病 传染性疾病
- 微生物学 微生物学
- 药理学 药理学是指药理学的学科.
背景情况:
- 困难菌感染 (CDI) 是一个重要的医疗保健挑战,特别是复发病例.
- 近年来,CDI治疗和预防策略取得了进展.
- 自2011年以来,美国FDA已经批准了四种新产品用于CDI治疗或预防复发.
研究的目的:
- 对Clostridioides difficile感染的当前和新兴治疗方法进行审查.
- 涵盖初级预防,积极的感染管理和复发性CDI预防.
- 包括关于便微生物群移植和活生物治疗的数据.
主要方法:
- 在多个数据库 (MEDLINE,EMBASE,Cochrane,Scopus) 进行全面的文献搜索,截至2023年5月1日.
- 专注于治疗性干预的CDI.
- 包括关于基于微生物组的疗法和单克隆抗体的数据.
主要成果:
- 不再建议在门诊CDI治疗中使用美特罗尼达.
- 对于第一个CDI发作,口服万科米辛或菲达克索米辛是最好的.
- 菲达克索米辛或万科米辛的缓慢脉冲疗法是复发性CDI的选择.
- 静脉注射贝兹洛托马布已被批准用于预防CDI复发.
- 有两种FDA批准的活生物疗法可用于预防复发性CDI.
- 在特定情况下,便微生物群移植仍然是复发性CDI的选择.
结论:
- 对CDI的治疗指导方针发生了变化,强调针对初始发作的特定口服药物.
- 新的治疗方案,包括基于微生物组的疗法和单克隆抗体,为预防复发性CDI提供了新的策略.
- 随着FDA批准的新药的引入,CDI管理的景观继续发展.
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