避免对新药产生耐药性:开放研究线路
Matteo Rinaldi1, Milo Gatti2, Maddalena Giannella1
1Infectious Diseases Unit, Department for Integrated Infectious Risk Management, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences, Alma Mater University of Bologna, Bologna, Italy.
概括
预防对新抗生素的耐药性包括优化新组合疗法的剂量和输液策略. 非抗微生物方法,如菌体疗法,也显示出降低多药耐药细菌威胁的希望.
科学领域:
- 微生物学与传染病的研究
- 药理学和治疗学 药理学和治疗学
- 公共卫生 公共卫生
背景情况:
- 耐多药格兰负细菌的兴起构成了全球重大健康挑战.
- 新型抗菌剂至关重要,但面临着新兴耐药性的威胁.
- 耐卡巴胺和难以治疗的细菌需要紧急关注.
研究的目的:
- 审查抗微生物和非抗微生物策略,以预防或减轻对新型抗菌剂的耐药性.
- 总结当前关于优化治疗方案和探索替代疗法的证据.
主要方法:
- 在过去5年内在PubMed-MEDLINE上发表的英语文章的叙事评论.
- 专注于药理动力学/药理动力学目标,组合治疗与单一治疗,以及非抗菌干预措施.
主要成果:
- 优化药理动力学/药理动力学目标,如持续输液和治疗药物监测,可以防止对新型β-乳酸/β-乳酸酶抑制剂组合产生耐药性.
- 目前,关于组合疗法比单一疗法对新型药物的常规益处的证据有限,需要进一步研究,以耐药性为终点.
- 包括便微生物群移植,菌体治疗和免疫在内的非抗微生物策略在高风险人群中显示出潜力.
结论:
- 目前针对新型β-乳酸/β-乳酸酶抑制剂的抗药性预防依赖于优化剂量和输液.
- 需要进一步的研究来澄清组合治疗方案的益处,以抗药性出现为关键终点.
- 非抗菌药物干预是对更广泛的耐药性预防框架的有希望的辅助工具,特别是在高风险环境中.
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