多黏菌素类药物的肾毒性及其优化给药方案研究进展

多重耐药及泛耐药革兰阴性菌的流行给临床抗感染治疗带来了巨大挑战.由于新型抗菌药物研究开发缓慢,多黏菌素这类曾因严重的神经毒性和肾毒性而逐渐停止使用的抗生素又重回人们视野,并成为了治疗重症难治性革兰阴性菌感染的主要药物.然而,肾毒性仍严重影响此类药物的临床治疗效果.其肾毒性机制复杂,并且临床上存在着许多肾毒性危险因素,因...

Research advances on the nephrotoxicity and optimal dosage regimens of polymyxins

The prevalence of multidrug-resistant and pan-resistant gram-negative bacteria has brought great challenges to the treatment of infections. Due to slow research and development of new antibiotics, polymyxins, previously disused because of serious neurotoxicity and nephrotoxicity, have been reused and become the major drugs for bacterial infections. However, nephrotoxicity still poses a significant hindrance for the clinical efficacies of polymyxins. The mechanism of nephrotoxicity is so complex that there are many clinical risk factors. For a more satisfactory therapeutic efficacy, it is necessary to carefully and comprehensively consider all the influencing factors when choosing the appropriate dosage regimen for individual patients. This paper reviewed the issues of nephrotoxicity and optimal dosage regimens of polymyxins for providing clinicians with some guidance for using polymyxin in anti-infective therapy.