久旱逢甘露之-- 新抗生素

creationrevolution.com

研發抗生素已被藥廠將近被忘記嘅事情
2014年FDA也有4隻新藥可用
香港唔知幾時會有

原來Ceftarolin 已經係2010年嘅事, 事隔幾年才登陸香江, 也不算是什麼新葯

"The FDA approval of ceftolozane/tazobactam (Zerbaxa) signifies several significant milestones in the battle against antibiotic-resistant superbugs. IDSA applauds Cubist and other public and private industry enterprises dedicated to helping combat the rise of antibiotic-resistant bacteria ... for their efforts to mitigate the sharp decline in the development of new antibiotics."
 
Other antibiotics approved in 2014 include three new agents with activity against methicillin-resistant Staphylococcus aureus (MRSA), indicated for acute skin and soft tissue infections in adults:

• Tedizolid, available oral or IV, and active against Gram-positive bacteria including Staphylococcus aureus (including methicillin-resistant [MRSA] and methicillin-susceptible [MSSA] isolates), Streptococcus pyogenes, Streptococcus agalactiae, Streptococcus anginosus Group (including Streptococcus inosus, Streptococcus intermedius, and Streptococcus constellatus), and Enterococcus faecalis.
• Dalbavancin, indicated for a similar antimicrobial spectrum as tedizolid, minus E. faecalis. Dalvance is available through the IV route only, but has the advantage of requiring only two 30-minute infusions one week apart.
• Oritavancin, with a similar antimicrobial spectrum as Sivextro, but given as a single IV dose to replace a 7-day course of vancomycin.

止嘔葯或有效降低中風後肺炎風險

disfagiabrasil.com

METHODS: Patients with no signs of pneumonia within 7 days of stroke onset and 48 hours of insertion of a nasogastric tube were recruited into a double-blind randomized placebo-controlled trial. Participants received metoclopramide 10 mg or placebo 3x daily via the nasogastric tube for 21 days or until nasogastric feeds were discontinued. Clinical signs of pneumonia were recorded daily. Pneumonia was diagnosed if the patient had relevant clinical signs, high inflammatory markers, and new infiltrates on the chest radiograph.

RESULTS: Sixty patients (mean age, 78 years; 38 women; mean National Institutes for Health Stroke Scale score, 19.25) were randomized in a 1:1 ratio. There were significantly more episodes of pneumonia in the placebo group than in the metoclopramide group (rate ratio, 5.24; P<0.001). There were also significant differences in favor of metoclopramide in the rate of aspiration, oxygen saturation, highest inflammatory markers, and National Institutes for Health Stroke Scale. There was no significant difference in mortality between the groups.

CONCLUSIONS: This study suggests that metoclopramide may reduce the rate of pneumonia and may improve other clinical outcomes in patients with subacute stroke fed via nasogastric tube. These findings need to be confirmed in larger randomized and blinded trials.


Warusevitane A, Karunatilake D, Sim J, et al. Safety and effect of metoclopramide to prevent pneumonia in patients with stroke fed via nasogastric tubes trial. Stroke. 2015 Feb;46(2):454-60.

但長期服用Metoclopramide也有其副作用