多黏菌素临床应用中国专家共识

Chinese expert consensus on polymyxins in the clinical practice

多黏菌素是从多黏芽孢杆菌培养液中获得的多肽类抗生素,于20世纪50年代上市并应用于临床,由于其肾毒性大被其他更安全的抗菌药物取代.近年来,随着多重耐药和广泛耐药革兰阴性杆菌感染发生率的不断上升,多黏菌素重新应用于临床,是治疗多重耐药和广泛耐药革兰阴性杆菌感染的有效药物.为规范多黏菌素的临床应用,我们组织相关领域专家,对多黏菌素的药代动力学与药效动力学特性、剂量和用法、禁忌证和相对禁忌证、临床应用及不良反应5个方面制定共识,供同道借鉴.

Polymyxin,a polypeptide antibiotic,derived from the culture of bacillus polymucilis,was introduced in the 1950s and used in clinical practice,but was replaced by safer antimicrobials due to its renal toxicity.In the recent years,with the increasing incidence of multidrug-resistant(MDR)and extensively drug-resistant(XDR)bacilli infections,polymyxin is reintroduced into the clinic because it is assumed an important role in the treatment of MDR infections and XDR infections.In order to regulate the clinical applications of polymyxin,we organized experts in relevant fields to develop expert consensus on polymyxin for reference,including parameters like pharmacokinetics and pharmacodynamics,dosage and usage,contraindications and relative contraindications,clinical applications and adverse reactions.