替考拉宁在耐甲氧西林金黄色葡萄球菌所致感染性心内膜炎的应用评价

发布时间：2018-05-07 23:24

本文选题：替考拉宁 + 耐甲氧西林金黄色葡萄球菌　；参考：《中国医院药学杂志》2017年11期

【摘要】：目的:评价替考拉宁在耐甲氧西林金黄色葡萄球菌(MRSA)所致感染性心内膜炎的应用。方法:通过比较2014-2015年国内外相关指南、共识及《抗菌药物临床应用指导原则(2015年版)》对MRSA所致感染性心内膜炎的推荐方案,提出有争议的问题:替考拉宁是否适用于治疗MRSA所致感染性心内膜炎?通过查询国内外文献,从循证医学证据、替考拉宁在心脏赘生物的分布、给药方案、治疗药物浓度监测等4个方面进行评价。结果:替考拉宁治疗MRSA所致感染性心内膜炎的循证医学证据还很少,有限的证据表明,替考拉宁常规剂量治疗感染性心内膜炎时,出现更高的失败率。定量放射自显影术显示,替考拉宁只分布在心脏赘生物的外围。替考拉宁用于治疗严重感染时,需要优化给药方案,并进行血药浓度监测。目前替考拉宁的治疗药物浓度监测还未广泛开展,不利于替考拉宁用于严重感染的治疗。结论:不推荐替考拉宁用于治疗MRSA所致的感染性心内膜炎。
[Abstract]:Objective: to evaluate the application of teicoplanin in the treatment of infective endocarditis induced by methicillin-resistant staphylococcus aureus. Methods: by comparing the relevant guidelines, consensus and guidelines for clinical application of antimicrobial agents (2015 edition) in 2014-2015, we compared the recommended schemes for infective endocarditis caused by MRSA. The controversial question is whether teicoplanin is applicable to the treatment of infectious endocarditis caused by MRSA. By consulting the literature at home and abroad, this paper evaluated the evidence of evidence-based medicine, the distribution of teicoplanin in cardiac neoplasm, the regimen of administration, and the monitoring of therapeutic drug concentration. Results: Evidence-based medical evidence of teicoplanin in the treatment of infective endocarditis caused by MRSA was scarce. Limited evidence indicated that teicoplanin had a higher failure rate in the treatment of infective endocarditis. Quantitative autoradiography showed that teicoplanin distributed only on the periphery of the cardiac neoplasm. When teicoplanin is used in the treatment of severe infections, it is necessary to optimize the administration protocol and to monitor the blood concentration of teicoplanin. Currently, tiicoplanin concentration monitoring has not been widely carried out, which is not conducive to the use of teicoplanin in the treatment of severe infection. Conclusion: teicoplanin is not recommended for the treatment of MRSA-induced infective endocarditis.
【作者单位】：福建医科大学附属泉州第一医院药剂科;
【基金】：福建省卫生计生委青年科研课题(编号:2014-2-50)
【分类号】：R542.41

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