抗菌药物防细菌耐药突变浓度理论及研究进展

目的：阐述防耐药突变浓度（MPC）和耐药突变选择窗理论（MSW）及该理论最新研究进展。方法：查阅近10年来国内外相关文献资料进行整理归纳。结果与结论：通过近年报道的体内外实验结果证明MPC和MSW是评价抗菌药物防细菌耐药能力的新指标。在应用抗菌药物时,应尽量缩小突变选择窗,力争遏制和延缓细菌耐药突变。除选择更理想的药物、调整药物剂量外,联合用药在理论上讲也是一条安全、有效的用药途径。AUC24/MPC,Cmax/MPC作为防止耐药突变的预测指标优于AUC24/MIC。根据防耐药突变理论选择应用抗感染药物为延缓耐药提出了新的策略。

Advances in studies on mutant prevention concentration rationale for antimicrobial agents

To review the recent research of mutant prevention concentration （MPC） and the latest progress. Reviews related to MPC in the recent ten years were reported in this paper. All these in vitro and in vivo studies indicated that MPC and mutant selective window （MSW） were new indexes to evaluate the antimicrobial resistance. During application of antibiotics, narrowing or closing the MSW, restraining and deplaying the bacteria-resistant mutant should try to be made. Besides selecting an ideal drug and optimizing the proper dosage, the combination therapy may be a safe and effective way to inhibit the development of resistance. AUC24/MPC is more appropriate than AUC24/MIC for predicting the restriction of resistant mutant emergence. It offers the ideal and new strategy for restricting resistant mutants and delaying antimicrobial resistance.