Daptomycin for the treatment of bacteraemia due to vancomycin-resistant enterococci.
Daptomycin for the treatment of bacteraemia due to vancomycin-resistant enterococci.
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DOI：
10.1016/j.ijantimicag.2014.08.002
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发表时间：
2014-11
影响因子：
10.8
通讯作者：
Arias CA
中科院分区：
文献类型：
--
作者：
Munita JM;Murray BE;Arias CA
由于缺乏可靠的替代治疗方法，万古霉素耐药肠球菌（VRE）引起的严重感染的治疗具有挑战性。在这种情况下，达托霉素（DAP），一种脂肽抗生素，已成为一种令人感兴趣的替代品，因为它是少数几种保留对VRE分离株体外杀菌活性的化合物之一，尽管它尚未被监管机构批准用于此目的。在这篇综述中，我们将总结的临床，动物和体外证据评估的有效性DAP的管理深层次的VRE感染。此外，我们将解决重要的临床问题，如治疗过程中出现的DAP耐药和DAP单药治疗失败的报告。最后，我们将讨论未来可能的策略（如使用更高剂量和/或联合治疗），以优化这种抗生素对VRE的使用。
Treatment of severe infections caused by vancomycin-resistant enterococci (VRE) is challenging due to the scarcity of reliable therapeutic alternatives. In this context, daptomycin (DAP), a lipopeptide antibiotic, has emerged as an interesting alternative as it is one of the few compounds that retain in vitro bactericidal activity against VRE isolates, although it has not been approved for this purpose by regulatory agencies. In this review, we will summarise the clinical, animal and in vitro evidence evaluating the efficacy of DAP for the management of deep-seated VRE infections. In addition, we will address important clinical concerns such as the emergence of DAP resistance during therapy and reports of therapeutic failure with DAP monotherapy. Finally, we will discuss possible future strategies (such as the use of higher doses and/or combination therapies) to optimise the use of this antibiotic against VRE.
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