本文選題：替考拉寧 + 耐甲氧西林金黃色葡萄球菌　； 參考：《中國醫(yī)院藥學(xué)雜志》2017年11期

【摘要】：目的:評價替考拉寧在耐甲氧西林金黃色葡萄球菌(MRSA)所致感染性心內(nèi)膜炎的應(yīng)用。方法:通過比較2014-2015年國內(nèi)外相關(guān)指南、共識及《抗菌藥物臨床應(yīng)用指導(dǎo)原則(2015年版)》對MRSA所致感染性心內(nèi)膜炎的推薦方案,提出有爭議的問題:替考拉寧是否適用于治療MRSA所致感染性心內(nèi)膜炎?通過查詢國內(nèi)外文獻,從循證醫(yī)學(xué)證據(jù)、替考拉寧在心臟贅生物的分布、給藥方案、治療藥物濃度監(jiān)測等4個方面進行評價。結(jié)果:替考拉寧治療MRSA所致感染性心內(nèi)膜炎的循證醫(yī)學(xué)證據(jù)還很少,有限的證據(jù)表明,替考拉寧常規(guī)劑量治療感染性心內(nèi)膜炎時,出現(xiàn)更高的失敗率。定量放射自顯影術(shù)顯示,替考拉寧只分布在心臟贅生物的外圍。替考拉寧用于治療嚴重感染時,需要優(yōu)化給藥方案,并進行血藥濃度監(jiān)測。目前替考拉寧的治療藥物濃度監(jiān)測還未廣泛開展,不利于替考拉寧用于嚴重感染的治療。結(jié)論:不推薦替考拉寧用于治療MRSA所致的感染性心內(nèi)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.
【作者單位】： 福建醫(yī)科大學(xué)附屬泉州第一醫(yī)院藥劑科;
【基金】：福建省衛(wèi)生計生委青年科研課題(編號:2014-2-50)
【分類號】：R542.41

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