Ayla ARSLAN, Hakan KUTLU, Osman MEMİKOĞLU, Gülden BOZKURT YILMAZ

4112

Yeni bir antibakteriyel ajan: DAPTOMİSİN

Dünya çapında artan antibiyotik direnci nedeniyle gram pozitif bakteri infeksiyonları, özellikle de Metisilin Dirençli S.aureus (MRSA), için yeni tedavi seçeneklerine ihtiyaç duyulmaktadır. Daptomisin ise geniş gram pozitif patojen etkinliğine sahip olan siklik lipopeptit sınıfı bir antimikrobiyaldir. Komplike deri ve yumuşak doku infeksiyonları, Staphylococcus aureus’un etken olduğu bakteriyemi ve sağ kalp infektif endokarditi için onay almıştır. Hızlı bakterisidal etkinliğinin yanında günde tek doz 4-6mg/kg infüzyon şeklinde uygulanmaktadır. Daptomisin ile kullanımda olan diğer geniş gram pozitif etkinliğe sahip olan 3 antibiyotiğin (vankomisin, linezolid, quinupristin-dalfopristin) Minimum İnhibitör Konsantrasyonları (MİK) karşılaştırılmış, MİK50 ve MİK90 değerleri daptomisin, vankomisin, linezolid ve quinupristin-dalfopristin için sırasıyla; 0.125mg/L-0.25mg/L, 1mg/L- 1.5mg/L, 0.5mg/L-0.75mg/L ve 0.5mg/L-0.75mg/L olarak hesaplanmıştır. Diğer antibakteriyellere göre en düşük MIC değerine sahip olan daptomisin dirençli gram pozitif patojenlerin neden olduğu infeksiyonların tedavisinde bir terapötik seçenek olarak karşımıza çıkmaktadır.

A novel antibacterial agent: DAPTOMYCİN

Novel antimicrobial agents are necessary for the treatment of infections caused by gram positive pathogens, especially by Meticillin resistant Staphylococcus aureus (MRSA), because of the increasing worldwide resistance. Daptomycin; which has activity against a wide spectrum of gram positive organisms, is a novel cyclic lipopeptide antimicrobial. It is indicated for the treatment of complicated skin and soft tissue infections, bacteremia and right side infective endocarditis caused by S. aureus. Beside once daily 4-6 mg/kg infusion dosing regimen it has a rapid bactericidal activity. MICs of daptomycin was compared with those of three antimicrobial agents (vancomycin, linezolid, quinupristin-dalfopristin) which has a activity against gram positive bacteriae. MIC50 and MIC90 values of daptomycin, vancomycin, linezolid and quinupristin-dalfopristin were determined as 0.125mg/L-0.25mg/L, 1mg/L-1.5mg/L, 0.5mg/L-0.75mg/L and 0.5mg/L-0.75mg/L, respectively. With having the lowest MIC values, daptomycin may represent a therapeutic option for the infections caused by gram positive pathogens.
PDF

___

  • 1. Tünger A. Staphylococcus aureus: Mikrobiyoloji, Patogenez ve Epidemiyoloji. Ulusoy S, Usluer G, Ünal S, editörler. Önemli ve sorunlu Gram Pozitif Bakteri İnfeksiyonları. 1st ed. Ankara: Bilimsel Tıp Yayınevi; 2004. p.9-22.
  • 2. Özaras R, Tabak F. Daptomisin. Klimik Dergisi 2010; 23(2):35-38.
  • 3. Smith K, Perez A, Ramage G et al. Comparison of biofilm-assciated cell survival following in vitro exposure of meticillinresistant Staphylococcus aureus biofilms to the antibiotics clindamycin, daptomycin, linezolid, tigecycline and vancomycin. Int J Antimicrob Agents 2009; 33:374-378.
  • 4. Silverman JA, Perlmutter NG, Shapiro HM. Antimicrob Agents Chemother 2003; 47: 2538-2544.
  • 5. Tedesco KL, Rybak MJ. Daptomycin. Pharmacothe-rapy 2004; 24(1):41-57.
  • 6. Hobbs JK, Miller K, O’Neill AJ et al. Conse-quences of daptomycin-mediated membrane damage in Staphylococcus aureus. J Antimicrob Chemother 2008; 62(5):1003-1008.
  • 7. Cha R, Grucz RG Jr, Rybak MJ. Daptomycin dose-effect relationship against resistant gram-positive organisms. Antimicrob Agents Chemother 2003;47(5):1598-603.
  • 8. Safdar N, Andes D, Craig W. In vivo pharmacodynamic activity of daptomycin. Antimicrob Agents Chemother 2004;48(1):63-68.
  • 9. Chakraborty A, Roy S, Loeffler J et al. Comparison of the pharmacokinetics, safety and tolerability of daptomycin in healthy adult volunteers following intravenous administration by 30 min infusion or 2 min injection. J Antimicrob Chemother 2009;64(1):151-158.
  • 10. Kosmidis C, Levine DP. Daptomycin: pharmacology and clinical use. Expert Opin Pharmacother 2010;11(4):615-625.
  • 11. Silverman JA, Mortin LI, Vanpraagh AD et al. Inhibition of daptomycin by pulmonary surfactant: in vitro modeling and clinical impact. J Infect Dis 2005;191(12):2149-2152.
  • 12. Raad I, Hanna H, Jiang Y et al. Comparative activities of daptomycin, linezolid and tigecycline against catheter-related methicillin- resistant Staphylococcus bacteremic isolates embedded in biofilm. Antimicrob Agents Chemother 2007;51(5):1656-1660.
  • 13. Barry AL, Fuchs PC, Brown SD. In vitro activities of daptomycin against 2,789 clinical isolates from 11 North American Medical Centers. Antimicrob Agents Chemother 2001;45(6):1919-1922.
  • 14. Carpenter CF, Chambers HF. Daptomycin: another novel agent for treating infections due to drug-resistant gram-positive pathogens. Clin Infect Dis 2004;38(7):994-1000.
  • 15. Critchley IA, Blosser-Middleton RS, Jones ME et al. Baseline study to determine in vitro activities of daptomycin against grampositive pathogens isolated in the United States in 2000-2001. Antimicrob Agents Chemother 2003;47(5):1689-1693.
  • 16. Snydman DR, Jacobus NV, McDermott LA et al. Comparative in vitro activities of daptomycin and vancomycin against resistant gram-positive pathogens. Antimicrob Agents Chemother 2000;44(12):3447-3450.
  • 17. Yılmaz Bozkurt G, Kutlu H, Aslan A et al. Klinik MRSA izolatlarında in vitro gram pozitif etkinlik: daptomisin, vankomisin, linezolid ve quinupristin/dalfopristin karşılaştırılması. 3.EKMUD Kongre Kitabı; 12-16 Mayıs, 2010; Ankara, Türkiye. S.324.
  • 18. Traczewski MM, Katz BD, Steenbergen JN et al. Inhibitory and Bactericidal Activity of Daptomycin, Vancomycin and Teicoplanin against Methicillin-Resistant Staphylococcus aureus Collected from 1985 to 2007. Antimicrob. Agents Chemother 2009;53(5):1735-1738.
  • 19. Cha R, Brown WJ, Rybak MJ. Bactericidal Activities of Daptomycin, Quinupristin- Dalfopristin, and Linezolid against Vancomycin- Resistant Staphylococcus aureus in an In Vitro Pharmacodynamic Model with Simulated Endocardial Vegetations. Antimicrob Agents Chemother 2003;7(12): 3960–3963.
  • 20. Crompton JA, North DS, Yoon M et al. Outcomes with daptomycin in the treatment of Staphylococcus aureus infections
Ankara Üniversitesi Tıp Fakültesi Mecmuası-Cover
  • Başlangıç: 1947
  • Yayıncı: Erkan Mor
Arşiv
Sayıdaki Diğer Makaleler

Memede tanımlanan eozinofilik anjiolenfoid hiperplazi

Fulya KÖYBAŞIOĞLU, Cemile Ayşe GÖRMELİ, Cüneyt YÜCESOY, Alper DİLLİ, Emine ÖZTÜRK, Zeynep Banu AYDIN, Bki HEKİMOĞLU

Polipoid tümöral kitleyi taklit eden gastrik varisler

Alper DİLLİ, Ö. Meriç TÜZÜN, Baki HEKİMOĞLU, Ümit Yaşar AYAZ

Pankreatikobilyer semptomları olan hastalarda insidental

Elif PEKER, Nuray HALİLOĞLU, Esra KAVUKÇU, Ayşe ERDEN

Osteoblastoma of the Cervical Spine: A Case Report

Nihat EGEMEN, Melih BOZKURT, Gökmen KAHİLOĞULLARI, Mevci ÖZDEMİR

Grip polikliniği verileri ışığında pandemik influenza salgını

Alpay AZAP, Emine Dilek ERÜZ, Evrim YANMAZ, Hakan KUTLU, Osman MEMİKOĞLU, Gülden BOZKURT YILMAZ, İsmail BALIK

Yeni bir antibakteriyel ajan: DAPTOMİSİN

Ayla ARSLAN, Hakan KUTLU, Osman MEMİKOĞLU, Gülden BOZKURT YILMAZ