The importance of bactericidal drugs: Future directions in infectious disease
The importance of bactericidal drugs: Future directions in infectious disease
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DOI：
10.1086/425009
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发表时间：
2004-11-01
影响因子：
11.8
通讯作者：
Rybak, MJ
中科院分区：
文献类型：
--
作者：
Finberg, RW;Moellering, RC;Rybak, MJ
背景虽然有相当多的研究已经进入了杀菌与抑菌抗菌剂在不同感染性疾病的治疗中的作用的研究，没有公认的实践标准。一组传染病专家回顾了现有的文献，试图为临床实践定义具体的建议。在中枢神经系统感染中，由于在这些临床情况下可能发生严重损害，因此生物体被杀死的速度可能是一个重要的决定因素。在人体研究和动物模型中，抑菌抗生素未能充分治疗心内膜炎已得到充分证实。大部分证据支持这样的概念，即在治疗心内膜炎和脑膜炎时，使用具有体外杀菌活性的抗菌药物是重要的。这一结论是基于人类和动物的数据。在大多数其他临床情况下，支持杀菌药物优于抑菌药物的数据并不存在，在某些情况下，动物模型也不支持这一概念。临床医生应该意识到，对一种生物体具有抑菌作用的药物实际上可能对另一种生物体或同一种生物体的另一种菌株具有杀菌作用。
Background. Although a considerable amount of research has gone into the study of the role of bactericidal versus bacteriostatic antimicrobial agents in the treatment of different infectious diseases, there is no accepted standard of practice.Methods. A panel of infectious diseases specialists reviewed the available literature to try to define specific recommendations for clinical practice.Results. In infections of the central nervous system, the rapidity with which the organism is killed may be an important determinant, because of the serious damage that may occur during these clinical situations. The failure of bacteriostatic antibiotics to adequately treat endocarditis is well documented, both in human studies and in animal models.Conclusion. The bulk of the evidence supports the concept that, in treating endocarditis and meningitis, it is important to use antibacterial agents with in vitro bactericidal activity. This conclusion is based on both human and animal data. The data to support bactericidal drugs' superiority to bacteriostatic drugs do not exist for most other clinical situations, and animal models do not support this concept in some situations. Clinicians should be aware that drugs that are bacteriostatic for one organism may in fact be bactericidal for another organism or another strain of the same organism.