达托霉素临床应用专家意见

Expert opinion on clinical application of daptomycin

全球范围内,革兰阴性杆菌是威胁患者安全的主要耐药菌,但革兰阳性球菌感染导致的治疗失败同样是临床难题。随着耐药革兰阳性球菌对糖肽类药物不敏感以及最低抑菌浓度不断高漂移,体外检测敏感而临床治疗失败的病例不断增多,临床上迫切需要有效的、新型抗菌药物用于救治革兰阳性球菌感染患者。达托霉素是一种新型环脂肽类抗生素,具有全新抗菌靶点和快速杀菌活性,可穿透生物膜,因其不导致菌体溶解,从而避免细菌内容物炎症介质释放引发的严重炎症反应,在治疗菌血症、感染性心内膜炎、复杂皮肤软组织感染等方面具有良好的临床应用价值。为合理应用达托霉素有效救治患者,中国研究型医院学会感染性疾病循证与转化专业委员会组织国内专家撰写达托霉素临床应用专家意见,以期为广大临床工作者提供借鉴。

Gram-negative bacilli are the main resistant bacteria that threaten the safety of patients globally,but the treatment failure caused by gram-positive cocci infection also remains a clinical problem.With the insensitivity of resistant gram-positive cocci to glycopeptides and the increasingly upward drift in the minimum inhibitory concentration,the number of cases that are sensitive in vitro but fail in clinical treatment is increasing,there is an urgent need for effective and new antimicrobial agents to treat patients with gram-positive cocci infection.Daptomycin is a new cyclic lipopeptide antibiotic,which has a new antibacterial target,rapid bactericidal activity,and can penetrate the biofilm.It does not lead to the dissolution of bacteria,thus avoid the serious inflammatory reaction due to the release of inflammatory mediators in bacterial content,it has a good clinical application value in the treatment of bacteremia,infective endocarditis,as well as complicated skin and soft tissue infection.In order to treat patients effectively and rationally with daptomycin,professional committee of evidence-based and transformation of infectious diseases of Chinese Research Hospital Association organized domestic experts to write expert opinion on clinical application of daptomycin,so as to provide reference for clinical medical staff.