康替唑胺在抗结核治疗中的应用前景  

Application Prospect of Contezolid in Anti-tuberculosis Treatment

作　　者：包紫薇 刘佳[1] 姚琳[1] 吴妹英[1] Bao Zi-wei;Liu Jia;Yao Lin;WU Mei-ying(Department of Pulmonary Medicine,Affiliated Infectious Disease Hospital of Soochow University(The Fifth People's Hospital of Suzhou),Suzhou Jiangsu 215013,China)

机构地区：[1]苏州大学附属传染病医院(苏州市第五人民医院)肺科,江苏苏州215013

出　　处：《抗感染药学》2023年第10期1018-1024,共7页Anti-infection Pharmacy

基　　金：苏州市临床医学中心(编号:szlcyxzx202108)。

摘　　要：目前,全球结核病防治形势不容乐观,发病率和死亡率居高不下,中国依然是全球结核病高负担国家之一。近年来,作为噁唑烷酮类药物的代表,利奈唑胺在耐药和重症结核病治疗中的应用日益广泛,因突出的抗菌疗效,其临床地位不断提升,但由于骨髓抑制、神经毒性、乳酸酸中毒、潜在药物间相互作用、治疗窗较窄等问题,利奈唑胺在长疗程的抗结核治疗中的短板日益凸显。新一代噁唑烷酮类药物康替唑胺具有与利奈唑胺相当甚至更强的抗菌活性,具有更低的骨髓抑制毒性、神经毒性、乳酸酸中毒发生风险,独特的代谢途径和良好的药代动力学特征,逐渐走入临床专业人士的视野。本文对当前结核病防治形势、利奈唑胺在结核病治疗中的地位和所遇挑战,以及康替唑胺的药学特点与其在抗结核方面的实验研究和临床探索进行了综述,为后续康替唑胺在耐药结核和重症结核中的进一步研究提供参考。Presently,the global situation of tuberculosis prevention and treatment is not optimistic,with high morbidity and mortality.China is still one of the countries with a high burden of tuberculosis in the world.In recent years,as a representative of oxazolidinone drugs,linezolid has been widely used in the treatment of drug-resistant and severe tuberculosis,and its clinical status has been continuously improved due to its outstanding antibacterial effect.However,because of problems such as myelosuppression,neurotoxicity,lactic acidosis,potential drug-drug interactions,and narrow therapeutic windows,etc.,the shortcomings of linezolid in long-term anti-tuberculosis treatment have become increasingly prominent.Contezolid,a new generation of oxazolidinone drug,has the antibacterial activity equivalent to or even stronger than linezolid,and has lower risks of myelosuppressive toxicity,neurotoxicity,and lactic acidosis,a unique metabolic pathway,and good pharmacokinetic profiles,so it has gradually attracted attention of clinical professionals.This article reviews the current situation of tuberculosis prevention and treatment,the status and challenges of linezolid in tuberculosis treatment,as well as the pharmaceutical characteristics of contezolid and experimental research and clinical exploration in anti-tuberculosis,so as to provide reference for the subsequent further studies of contezolid in drug-resistant tuberculosis and severe tuberculosis.

关 键 词：康替唑胺 利奈唑胺 耐多药结核 噁唑烷酮类药物 临床应用 

分 类 号：R978.3[医药卫生—药品]