多黏菌素联合用药研究进展

Research progress on combination of polymyxins

由于抗菌药物的不合理使用,导致大量多重耐药(multidrug resistant,MDR)甚至泛耐药(extensive dru g resistant,XDR)和全耐药(pan-drug resistant,PDR)细菌的广泛流行,而新型抗菌药物尤其是抗革兰阴性菌药物的研发上市进程缓慢,使临床应对MDR革兰阴性菌感染的形势更为严峻。目前仅有替加环素和多黏菌素类(polymyxins)药物对MDR革兰阴性菌仍保持较高的抗菌活性,但在临床展开使用后,近期也出现了替加环素和polymyxins耐药报道。因此,为了有效控制MDR革兰阴性菌所致严重感染,防止耐药性的进一步产生,联合用药成为一个较好的选择。本文就国内外近年来以polymyxins为基础的联合用药研究进展做一综述。

Due to the irrational use of anti-bacterial agents, a large number of multidrug resistant （MDR） and even extensive drug resistant （XDR） and pan-drug resistant （PDR） bacteria widespread. While the development of new antibiotics particularly anti-gram-negative bacteria agents is slow. Therefore, the clinical response to the situation of MDR gram-negative bacterial infections is more severe. Currently, only tigecycline and polymyxins bacteria remaines high activity to MDR gram-negative. After the wide range of clinical use, the emergence of clinical resistance to tigecycline and polymyxins have been reported. In order to effectively control serious infections caused by MDR gram-negative and prevent further resistance, the combination of antibiotics may be a better choice. This article reviewed the combination therapy progress of polymyxins in recent years.