Streptococcus pneumoniae: Activity of Newer Agents Against Penicillin-Resistant Strains.
Streptococcus pneumoniae: Activity of Newer Agents Against Penicillin-Resistant Strains.
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DOI：
10.1007/s11908-999-0004-8
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发表时间：
1999-04-01
影响因子：
3.1
通讯作者：
Appelbaum
中科院分区：
文献类型：
--
作者：
Jacobs;Appelbaum
各大洲都报告了对抗菌剂有抗药性的肺炎球菌菌株。1997年，美国超过50%的菌株对青霉素不敏感，30%对大环内酯类耐药。此外，许多菌株对多种药物具有耐药性，包括β-内酰胺类、大环内酯类、克林霉素、氯霉素、四环素类和甲氧苄啶-磺胺甲恶唑。虽然非脑膜炎感染中β-内酰胺类抗生素的耐药性通常可以通过胃肠外给药克服，但临床显著耐药性是脑膜炎和口服β-内酰胺类抗生素的重要限制。肺炎球菌感染的治疗决定是基于感染部位、对青霉素G的耐药性程度、对其他药物的耐药性、疾病的严重程度、基础疾病的存在以及抗菌药物的剂量和给药途径。药代动力学和药效学变量在肺炎球菌中的应用极大地改善了药敏数据的解释和临床相关折点的制定。
Strains of pneumococci resistant to antimicrobial agents have been reported on all continents. In 1997, more than 50% of strains in the United States were not susceptible to penicillin, and 30% were resistant to macrolides. In addition, many strains are resistant to multiple agents, including beta-lactams, macrolides, clindamycin, chloramphenicol, tetracyclines, and trimethoprim-sulfamethoxazole. Although resistance to beta-lactams in nonmeningeal infections can usually be overcome by parenteral administration, clinically significant resistance is an important limitation in meningitis and with oral administration of beta-lactams. Decisions about treatment of pneumococcal infection are based on the site of infection, the degree of resistance to penicillin G, the presence of resistance to other agents, the severity of disease, the presence of underlying conditions, and the dose and route of administration of antimicrobial agents. The application of pharmacokinetic and pharmacodynamic variables to pneumococci has greatly improved the interpretation of susceptibility data and the development of clinically relevant breakpoints.