多黏菌素类联合其他抗菌药物治疗耐碳青霉烯类革兰阴性菌感染的研究进展

Research progress of Polymyxins combined with other antibiotics in the treatment of carbapenem-resistant gram-negative bacteria infection

随着耐碳青霉烯类革兰阴性菌检出率不断增加,多黏菌素类抗菌药物成为治疗耐碳青霉烯类革兰阴性菌感染的一种重要选择。但单一多黏菌素类抗菌药物治疗存在局限性,如常规剂量效果不佳,而增加剂量又会导致不良反应和耐药风险增加等。目前以多黏菌素类抗菌药物为基础的多药联合方案广泛应用于耐碳青霉烯类革兰阴性菌感染的治疗,但最佳联合治疗方案,以及不同联合治疗方案的安全性、有效性等尚无一致的定论。本文对基于多黏菌素类抗菌药物的联合用药方案在治疗耐碳青霉烯鲍曼不动杆菌、肺炎克雷伯菌和绿假单胞菌等革兰阴性菌感染的体内、体外研究进展进行综述,以期为多黏菌素类抗菌药物用于耐碳青霉烯类革兰阴性菌所致感染的治疗提供相关依据。

With the increasing detection rate of carbapenem resistant Gram-negative bacteria(CR-GNB),polymyxins(PMs)were to be the crucial escort in the treatment of CR-GNB infections.However,the single PM treatment has some limitations,such as insufficient efficacy at conventional doses and increasing the risk of adverse reactions and/or resistance when the dose increased.At present,PMs-based multi-drug combination regimens are widely used in the treatment of CR-GNB infection,however,there is still no consensus on the optimal combination regimen and the safety and effectiveness of different combination regimens.Therefore,this paper reviewed the in vitro and in vivo studies about combined drug regimen based on PMs in the treatment of CR-GNB infection,in order to provide relevant evidence for the application of PMs in the clinical treatment of CR-GNB-induced infection.