Polimiksinlerin ve Fosfomisinin Etki Spektrumu ve Kullanım Alanları
Özet
Paenibacillus polymyxa'dan izole edilen polimiksinler 1950'lerde klinik kullanıma girmişlerdir. Gram negatif bakterilerin hücre zarındaki lipopolisakkaritlere ve fosfolipidlere bağlanan bakterisidal ilaçlardır. Karbapenem dirençli enterik patojenler, Pseudomonas aeruginosa ve Acinetobacter baumannii gibi çoklu ilaca dirençli organizmaların tedavilerinde kullanılırlar. Fosfomisin, fosfonik antibiyotik sınıfının üyesi olarak 1969'da keşfedilmiştir. Sistemik enfeksiyonlarda parenteral kullanılmakta olup yalnızca komplike olmayan sistitte kullanılan oral formülasyonu mevcuttur. Fosfoenol-piruvat sentetazın inhibisyonu yoluyla hücre duvarı sentezini inhibe eder, stafilokoklara, enterokoklara, Haemophilus spp'ye, çoğu enterik gram-negatif bakteriye karşı geniş spektrumlu bakterisidal aktiviteye sahiptir. Dünya Sağlık Örgütü’nün rezerv antibiyotikler olarak ilan ettiği fosfomisin ve polimiksinlerin etkinliğini korumak, direnç gelişimini önlemek, uzun ömürlerini korumanın anahtarıdır.
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