分枝杆菌脓肿复合体(MABC)是一组耐酸,快速分裂的非结核分枝杆菌(NTM),包括许多临床上重要的亚种,包括M.脓肿,M.bolletii,还有M.Massiliense.这些生物在环境中普遍存在,主要与人的肺部或皮肤和皮肤结构感染(SSSI)有关,但可能会导致免疫受损的深层播散性感染和菌血症。重要的是,这些NTM对大多数一线抗结核药具有抗性,由于内在或后天的抵抗力,展品极低,变量,和地理上不同的敏感性常用的抗菌剂,包括老四环素,大环内酯类,氨基糖苷类,头孢菌素,碳青霉烯类,和磺胺甲恶唑-甲氧苄啶。Omadacycline是四环素抗菌药物家族的新第三代成员,最近已被证明具有有效的抗NTM作用和对MABC的临床疗效。包括M.脓肿.这篇综述的目的是对有关omadacycline在脓肿分枝杆菌感染中的作用的文献进行全面和最新的评估。具体来说,体外和体内微生物学,行动机制,抵抗机制,临床药代动力学,临床疗效,不利影响,剂量和给药,将详细介绍奥马环素在治疗脓肿分枝杆菌感染中的作用。
The Mycobacterium abscessus complex (MABC) is a group of acid-fast, rapidly dividing non-tuberculous mycobacteria (NTM) that include a number of clinically important subspecies, including M. abscessus, M. bolletii, and M. massiliense. These organisms are prevalent in the environment and are primarily associated with human pulmonary or skin and skin structure infections (SSSI) but may cause more deep-seeded disseminated infections and bacteremia in the immunocompromised. Importantly, these NTM are resistant to most first-line anti-tuberculous agents and, due to intrinsic or acquired resistance, exhibit exceedingly low, variable, and geographically distinct susceptibilities to commonly used antibacterial agents including older tetracyclines, macrolides, aminoglycosides, cephalosporins, carbapenems, and sulfamethoxazole-trimethoprim. Omadacycline is a novel third-generation member of the tetracycline family of antibacterials that has recently been demonstrated to have potent anti-NTM effects and clinical efficacy against MABC, including M. abscessus. The purpose of this
review is to present a comprehensive and up-to-date assessment on the body of literature on the role of omadacycline for M. abscessus infections. Specifically, the in vitro and in vivo microbiology, mechanisms of action, mechanisms of resistance, clinical pharmacokinetics, clinical efficacy, adverse effects, dosage and administration, and place in therapy of omadacycline in management of M. abscessus infections will be detailed.