杀菌剂与静菌抗菌剂:临床意义,差异和协同潜力在临床实践中
Angela Ishak1, Nikolaos Mazonakis2, Nikolaos Spernovasilis3,4
1Department of Internal Medicine, 48202 Henry Ford Hospital, Detroit, MI, USA.
The Journal of antimicrobial chemotherapy
|October 29, 2024
概括
细菌静止抗生素对许多感染,甚至是严重病例,与杀菌剂同样有效. 杀菌剂和细菌静止剂的组合可能不具有对抗作用,并且可以在临床上有用,特别是在抗菌素耐药性上升的情况下.
科学领域:
- 微生物学 微生物学
- 药理学 药理学是指药理学的学科.
- 传染性疾病 传染性疾病
背景情况:
- 抗菌活性被分为杀菌性或静菌性,但这种区分在临床实践中具有挑战性.
- 定义抗菌活性的实验室条件可能不反映现实世界的临床环境.
- 人们普遍认为杀菌剂优于静菌剂,特别是在严重的感染中.
研究的目的:
- 审查和评估杀菌剂和细菌静止剂之间的抗菌活性差异.
- 检查结合杀菌剂和细菌静止抗菌剂的对抗性或协同效应.
- 评估细菌静止剂在各种感染中的临床有效性.
主要方法:
- 审查了体外和体内研究.
- 分析了在不同类型的感染中使用细菌静止剂的临床数据.
- 研究了联合抗菌疗法的对抗性和协同效应.
主要成果:
- 细菌静止剂,如线索利德和tigecycline,在肺炎,腹腔内和皮肤感染中显示出与杀菌剂相比的临床非劣势.
- 细菌静止剂显示出希望作为重症感染的救援疗法,包括中性衰竭发烧和内心炎.
- 并非所有细菌静止剂和杀菌剂的组合都具有抗菌作用;有些,如线胺和利芬素,已经在使用中.
结论:
- 在临床实践中,细菌杀菌和细菌静止活性之间的区别不如以前认为的那么重要.
- 细菌静止剂可以是杀菌剂的有效替代品或辅助剂,即使在严重的感染中也是如此.
- 需要进一步的随机对照试验来确认细菌静止剂及其组合的有效性,特别是在抗菌素耐药性增加的背景下.
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