肽类抗生素的进展与临床应用评价

Advances in Peptide Antibiotics and Clinical Evaluation

目的:肽类抗生素是继β-内酰胺类、氨基糖苷类和大环内酯类抗生素后问世的一类具有全新作用机制的抗菌药物,虽抗菌谱较窄,但杀菌活性强大,耐药性发生率较低,本文介绍其发展进程和合理应用的侧面。方法:采用国内、外近期文献综述。结果及结论:体内外试验显示,肽类抗生素对革兰阳性菌包括耐甲氧西林金葡菌、甲氧西林敏感金葡菌、凝固酶阴性葡萄球菌、链球菌、难辨梭菌等具有抗菌活性,对革兰厌氧菌也具有活性。近年来,其在应用上东山再起,在治疗感染性心内膜炎、抗生素相关性腹泻、导管相关性感染、呼吸系统感染、皮肤与软组织感染上已取得良好疗效。

OBJECTIVE：Peptide antibiotics are a new kind of antimicrobiahherapeutic drugs with new mechanisms of action following beta- lactamase, aminoglycosides and macrolides. In spite of narrow antibacterial spectrum, this new kind of antibiotics has strong bactericidal activity and low incidence of drug resistance. This paper summarized the advances and the rational use of peptide antibiotics. METHODS： We reviewed the recent pertinent literature both home and abroad. RESULTS ＆ CONCLUTION： The in - vitro and in - vivo tests showed that peptide antibiotics had antibacterial activities against gram - positive bacteria, including meticillin resistant staphylococcus anreus, meticillin sensitive staphylococcus aureus, coagulase negative staphylococcus streptococcus and clostridium difficile. It was also active against antimicrobial gram - anaerobian. Recently, its use has staged to a comeback, and it was proved to be an therapy of efficacy and safety for infectious endocarditis, antibiotic associated diarrhea, catheter related infection, infections of respiratory system, skin and soft tissue.