替加环素
医学
利奈唑啉
万古霉素
达托霉素
败血症
重症监护医学
背景(考古学)
金黄色葡萄球菌
耐甲氧西林金黄色葡萄球菌
抗菌剂
抗药性
感染性休克
抗生素耐药性
革兰氏阴性细菌感染
菌血症
抗生素
经验性治疗
内科学
梅德林
微生物学
克
细菌
生物
古生物学
遗传学
作者
Matteo Bassetti,Francesca Ginocchio,Daniele Roberto Giacobbe
出处
期刊:PubMed
日期:2011-08-01
卷期号:77 (8): 821-7
被引量:7
摘要
Nosocomial bloodstream infections (BSIs) have become an important cause of morbidity and mortality, particularly in intensive care units (ICUs). Gram-positive organisms are the prevalent causes of antibiotic-resistant BSI, especially Staphylococcus aureus, coagulase-negative staphylococci and enterococci. In recent years, several reports have shown an increase in antimicrobial resistance among Gram-positive bacteria isolated from patients in ICUs. In this context, methicillin-resistant Staphylococcus aureus (MRSA) is a major problem. In the ICU more than 50% of S. aureus isolates in Europe are resistant to methicillin. Although vancomycin became the drug of choice for MRSA and is still widely used for this indication, many studies suggest that when vancomycin MIC values are at the high end of the susceptibility range, vancomycin is less effective against MRSA. High MRSA prevalence combined with the widespread use of vancomycin for empirical Gram-positive coverage may lead to changes in patient outcomes. Here we describe the microbiological, pharmacological and clinical characteristics of three new antibacterials helpful in severe infections in ICU patients: linezolid, tigecycline and daptomycin. These new drugs have some limitations, and the possibility developing resistance is real. Knowledge of both old and new antibacterials is necessary to utilize them most effectively.
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