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J Antimicrob Chemother:达托霉素治疗VRE菌血症,高剂量还是标准剂量?

2018-09-19 吴星 环球医学

在美国,VRE与每年约1300例死亡相关。近期的文献表明,达托霉素,一种具有浓度依赖杀菌活性的环状脂肽抗生素,是VRE菌血症的首选治疗方法,然而该适应证的最佳给药策略还未确立。

在美国,VRE与每年约1300例死亡相关。近期的文献表明,达托霉素,一种具有浓度依赖杀菌活性的环状脂肽抗生素,是VRE菌血症的首选治疗方法,然而该适应证的最佳给药策略还未确立。

体外证据显示,需要高于标签剂量的达托霉素来最佳治疗VRE菌血症,和抑制耐药性的发生。然而,对剂量依赖毒性、肌酸磷酸激酶的显著增加、横纹肌溶解症的发生等的担忧,是临床实践中初始高剂量方案的障碍。因此,高剂量达托霉素在临床实践中的有效性和安全性仍然未知。

虽然早期研究未能鉴别出死亡率上的差异,但新型更大型的调查表明,与标准剂量(6mg/kg)相比,高剂量(≥9mg/kg)达托霉素与VRE菌血症患者死亡率的降低相关。此外,高剂量方案貌似是安全的,并与微生物学结局的改善相关。

本综述的目的为审查高剂量vs标准剂量达托霉素治疗VRE菌血症的有效性和安全性的公开发表的证据。相关报告发表在2018年9月《J Antimicrob Chemother》。

原始出处:

Foolad F, Taylor BD, Shelburne SA, et.al. Association of daptomycin dosing regimen and mortality in patients with VRE bacteraemia: a review. J Antimicrob Chemother. 2018 Sep 1;73(9):2277-2283. doi: 10.1093/jac/dky072.

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    2018-11-01 xjy02
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    2019-08-25 amy0550
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    2018-09-21 lidong46
  7. [GetPortalCommentsPageByObjectIdResponse(id=1857699, encodeId=57f2185e699f6, content=<a href='/topic/show?id=3f48525849' target=_blank style='color:#2F92EE;'>#CRO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5258, encryptionId=3f48525849, topicName=CRO)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c30265, createdName=jiafufeng@yaho, createdTime=Fri Oct 12 12:29:00 CST 2018, time=2018-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2061209, encodeId=079d20612093e, content=<a href='/topic/show?id=08d2619182f' target=_blank style='color:#2F92EE;'>#标准剂量#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61918, encryptionId=08d2619182f, topicName=标准剂量)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ffd5416, createdName=bettycmoon, createdTime=Thu Nov 22 10:29:00 CST 2018, time=2018-11-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2084440, encodeId=44a3208444006, content=<a href='/topic/show?id=61f411e013b' target=_blank style='color:#2F92EE;'>#Micro#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11701, encryptionId=61f411e013b, topicName=Micro)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d59291, createdName=xjy02, createdTime=Thu Nov 01 18:29:00 CST 2018, time=2018-11-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1942100, encodeId=34bb19421007e, content=<a href='/topic/show?id=065b1022341a' target=_blank style='color:#2F92EE;'>#高剂量#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102234, encryptionId=065b1022341a, topicName=高剂量)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=010d202, createdName=amy0550, createdTime=Sun Aug 25 11:29:00 CST 2019, time=2019-08-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1303950, encodeId=df5d1303950d6, content=<a href='/topic/show?id=d1a0880e7c8' target=_blank style='color:#2F92EE;'>#菌血症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88077, encryptionId=d1a0880e7c8, topicName=菌血症)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e5bc315, createdName=Tommy1949, createdTime=Fri Sep 21 09:29:00 CST 2018, time=2018-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1587730, encodeId=239e158e730da, content=<a href='/topic/show?id=06f51853363' target=_blank style='color:#2F92EE;'>#VRE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=18533, encryptionId=06f51853363, topicName=VRE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=95d617567021, createdName=lidong46, createdTime=Fri Sep 21 09:29:00 CST 2018, time=2018-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345715, encodeId=4b74345e15ed, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82311653708, createdName=医者仁心5538, createdTime=Wed Sep 19 20:32:12 CST 2018, time=2018-09-19, status=1, ipAttribution=)]
    2018-09-19 医者仁心5538

    学习了

    0

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