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[β-内酰胺类抗生素]

[Beta-lactam antibiotics].

作者信息

Suárez Cristina, Gudiol Francesc

机构信息

Servicio de Enfermedades Infecciosas, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, España.

出版信息

Enferm Infecc Microbiol Clin. 2009 Feb;27(2):116-29. doi: 10.1016/j.eimc.2008.12.001. Epub 2009 Feb 15.

Abstract

Beta-lactam drugs, whose mechanism of action is inhibition of the last stage of bacterial cell wall synthesis, are the largest family of antimicrobial agents and the most widely used in current clinical practice. These drugs have a slow, time-dependent bactericidal action, generally good distribution in the body, and low toxicity. Modifications of the original molecule have led to new compounds with a greater antimicrobial spectrum and activity; nonetheless, the use and efficacy of beta-lactams is limited in some clinical settings, owing to the increasing emergence of antimicrobial resistance. Despite this problem, penicillin remains the treatment of choice in a large number of infections, cephalosporins have a wide range of indications, carbapenems are used in nosocomially-acquired infection and infection caused by multiresistant microorganisms, and beta-lactam inhibitors restore the spectrum of activity of their companion penicillins (aminopenicillins, ureidopenicillins) when resistance is caused by beta lactamase production.

摘要

β-内酰胺类药物的作用机制是抑制细菌细胞壁合成的最后阶段,是最大的一类抗菌药物,也是目前临床实践中使用最广泛的药物。这些药物具有缓慢的、时间依赖性的杀菌作用,在体内分布一般良好,且毒性较低。对原始分子的修饰产生了具有更广抗菌谱和活性的新化合物;尽管如此,由于抗菌耐药性的不断出现,β-内酰胺类药物在某些临床环境中的使用和疗效受到限制。尽管存在这个问题,青霉素在大量感染中仍然是首选治疗药物,头孢菌素具有广泛的适应证,碳青霉烯类用于医院获得性感染和由多重耐药微生物引起的感染,当耐药性是由β-内酰胺酶产生导致时,β-内酰胺酶抑制剂可恢复其配伍青霉素(氨基青霉素、脲基青霉素)的活性谱。

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