Doripenem一水,一种广谱碳青霉烯抗生素。

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马修斯SJ,兰开斯特JW

Doripenem一水,一种广谱碳青霉烯抗生素。

其他。2009年1月,31 (1):42 - 63。doi: 10.1016 / j.clinthera.2009.01.013。

PubMed ID

19243706 (在PubMed

]

文摘

背景:Doripenem一水,一种广谱碳青霉烯抗生素,已通过美国食品和药物管理局(fda)治疗复杂腹腔感染(cIAIs)和复杂的尿路感染(皮肤)。目的:本文综述doripenem可用信息在患者的管理复杂的细菌感染,包括其化学、光谱的活动、耐药机制、药物动力学、药效学、药物相互作用、治疗效果、耐受性、计量和管理。还讨论了与doripenem pharmacoeconomic因素相关。方法:相关的英文文献被搜索的MEDLINE(1996 - 2008年10月)和生命现象(1993 - 2008年10月)。必威国际app必威国际app搜索条件包括,但不限于,doripenem, s - 4661,的活动,阻力,药理学,药物动力学、药效学、不良事件及治疗使用。额外的出版物被发现通过搜索确定文章的引用列表和审查会议的摘要抗菌药物和化疗跨必威国际app学科会议上(2003 - 2007)。结果:Doripenem是肠外碳青霉烯抗生素对革兰氏阳性和体外活性,革兰氏阴性,厌氧生物。它是对各种beta-lactamases稳定,包括extended-spectrum和AmpC beta-lactamases;然而,由生物体产生类酶灭活,KPC酶B类金属-β-内酰胺酶和类D的酶。Doripenem主要是消除尿液中(68% - -80%不变)。 It should be used cautiously in patients receiving valproic acid, as combined use may lead to a precipitous decline in serum concentrations of valproic acid. A large Phase III study in the treatment of cIAIs found doripenem noninferior to meropenem (clinical cure rates, 83.9% and 85.9%, respectively; difference, -2.1; 95% CI, -9.8 to 5.6). A Phase III study in the treatment of cIAIs, including pyelonephritis, found doripenem non-inferior to levofloxacin (clinical cure rates, 95.1% and 90.2%, respectively; 95% CI, 0.2 to 9.6). With respect to the treatment of nosocomial pneumonia, one Phase III study found doripenem noninferior to imipenem (clinical cure rates, 68.3% and 64.8%, respectively; difference, 3.5%; 95% CI, -9.1 to 16.1), and another found it noninferior to piperacillin/tazobactam (clinical cure rates, 81.3% and 79.8%, respectively; difference, 1.5%; 95% CI, -9.1 to 12.1). Adverse events with doripenem were similar to those of other antibiotics with which it has been compared. Adverse events in clinical trials of doripenem have included anaphylaxis and rash (l%-5%), gastrointestinal effects (25%-32%, including nausea [1.1%-12.0%], diarrhea [1.9%-11.0%], and vomiting [1.5%-6.6%]), and central nervous system effects (headache [2.1%-16.0%], insomnia [3.7%], anxiety [2.9%], and, rarely, seizures). CONCLUSIONS: In Phase III studies, doripenem was noninferior to meropenem in the treatment of cIAIs; noninferior to levofloxacin in the treatment of cUTIs; and noninferior to imipenem and piperacillin/tazobactam in the treatment of nosocomial pneumonia. As with all new antibiotics, because of the risk of selecting for resistant organisms, use of doripenem should be reserved for infections in which a multidrug-resistant gram-negative organism, polymicrobial infection, or Pseudomonas aeruginosa is suspected.

DrugBank数据引用了这篇文章

药物

Doripenem

药物靶点

药物	目标	类	生物	药理作用	行动
Doripenem	Penicillin-binding蛋白1	蛋白质	大肠杆菌(应变K12)	是的	拮抗剂 抑制剂	细节
Doripenem	Penicillin-binding蛋白质1 b	蛋白质	大肠杆菌(应变K12)	是的	拮抗剂 抑制剂	细节
Doripenem	Penicillin-binding蛋白2	蛋白质	大肠杆菌(应变K12)	是的	拮抗剂 抑制剂	细节
Doripenem	Penicillin-binding蛋白3	蛋白质	铜绿假单胞菌	是的	拮抗剂 抑制剂	细节