Pharmacokinetics/pharmacodynamics of colistin and polymyxin B: are we there yet?
Pharmacokinetics/pharmacodynamics of colistin and polymyxin B: are we there yet?
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大肠杆菌蛋白和多粘蛋白B的药代动力学/药效学B：我们在那里吗？
DOI：
10.1016/j.ijantimicag.2016.09.010
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发表时间：
2016-12
影响因子：
10.8
通讯作者：
Li J
中科院分区：
文献类型：
--
作者：
Tran TB;Velkov T;Nation RL;Forrest A;Tsuji BT;Bergen PJ;Li J
多粘菌素抗生素[粘菌素和多粘菌素B（PMB）]越来越多地用作治疗广泛耐药革兰氏阴性菌引起的感染的最后一线选择。尽管具有相似的结构和体外抗菌活性，但这两种临床上可用的多粘菌素具有非常不同的药理学性质，因为粘菌素（多粘菌素E）以无活性前药甲磺酸粘菌素（钠）的形式静脉内给予患者。本文将讨论粘菌素和PMB的药代动力学/药效学和毒性的最新进展，影响其药理学特征的因素，以及有效使用这两种多粘菌素的挑战。根据最近的体外、动物和患者药理学研究，提出了优化其临床应用的策略。在“有害细菌，没有药物”的时代，多粘菌素是对抗难以治疗的革兰氏阴性“超级细菌”的抗生素的重要组成部分。必须寻求合理的方法来使用多粘菌素，以提高其有效性，并尽量减少耐药性和毒性。
The polymyxin antibiotics [colistin and polymyxin B (PMB)] are increasingly used as a last-line option for the treatment of infections caused by extensively drug-resistant Gram-negative bacteria. Despite having similar structures and antibacterial activity in vitro, the two clinically available polymyxins have very different pharmacological properties, as colistin (polymyxin E) is intravenously administered to patients in the form of an inactive prodrug colistin methanesulphonate (sodium). This review will discuss recent progress in the pharmacokinetics/pharmacodynamics and toxicity of colistin and PMB, the factors that affect their pharmacological profiles, and the challenges for the effective use of both polymyxins. Strategies are proposed for optimising their clinical utility based upon the recent pharmacological studies in vitro, in animals and patients. In the ‘bad bugs, no drugs’ era, polymyxins are a critically important component of the antibiotic armamentarium against difficult-to-treat Gram-negative ‘superbugs’. Rational approaches to the use of polymyxins must be pursued to increase their effectiveness and to minimise resistance and toxicity.
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影响因子：
4.9
作者：
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通讯作者：
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作者：
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通讯作者：
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4.9
作者：
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通讯作者：
Giamarellou, Helen