RESUMEN
The development of mechanisms of resistance of many Gram-positive bacterial strains that cause complicated skin and soft tissue infections, as well as sepsis and bacteremia, has necessitated the search for new drugs that will improve treatment strategies. Daptomycin is a cyclic lipopeptide antibacterial that was launched for the treatment of complicated skin and soft tissue infections caused by Gram-positive organisms. The drug's mechanism of action is different from that of any other antibiotic. It binds to bacterial membranes and causes a rapid depolarization of membrane potential. This loss of membrane potential causes inhibition of protein, DNA and RNA synthesis, which results in bacterial cell death. The in vitro spectrum of activity of daptomycin encompasses most clinically relevant aerobic Gram-positive pathogenic bacteria. Compared to other antibiotics with a similar antibacterial spectrum, daptomycin does not cause nephrotoxicity. Taking these and other characteristics into consideration, daptomycin appears to be a good alternative to other drugs used in the treatment of complicated skin and soft tissue infections and in Gram-positive bacteremial infections.
Asunto(s)
Antibacterianos/uso terapéutico , Daptomicina/uso terapéutico , Infecciones por Bacterias Grampositivas/tratamiento farmacológico , Animales , Antibacterianos/efectos adversos , Antibacterianos/economía , Antibacterianos/farmacología , Membrana Celular/efectos de los fármacos , Daptomicina/efectos adversos , Daptomicina/economía , Daptomicina/farmacología , Modelos Animales de Enfermedad , Costos de los Medicamentos , Evaluación Preclínica de Medicamentos , Farmacorresistencia Bacteriana Múltiple/fisiología , Sinergismo Farmacológico , Quimioterapia Combinada , Bacterias Grampositivas/efectos de los fármacos , Bacterias Grampositivas/fisiología , Humanos , Potenciales de la Membrana/efectos de los fármacos , Ratones , Conejos , Ensayos Clínicos Controlados Aleatorios como Asunto/estadística & datos numéricos , Infecciones Estafilocócicas/tratamiento farmacológico , Infecciones Estreptocócicas/tratamiento farmacológicoRESUMEN
El desarrollo de mecanismos de resistencia por parte de muchas bacterias grampositivas causantes de infecciones complicadas de la piel y los tejidos blandos, así como de sepsis y bacteriemias, ha hecho necesarias la búsqueda y la investigación de nuevos fármacos con el fin de ampliar, o al menos recuperar, las posibilidades de tratamiento. La daptomicina es un antibiótico con estructura de lipopéptido cíclico, activo exclusivamente sobre bacterias grampositivas. Su particular mecanismo de acción hace que presente una baja tasa de resistencias primarias. Puede ser bactericida y de forma muy rápida. Además de su eficacia, demostrada en ensayos clínicos, cabe destacar su actividad sobre distintos grampositivos en diferentes modelos experimentales. La ausencia de nefrotoxicidad lo sitúa en una posición ventajosa frente a otros antibióticos con espectro antibacteriano similar. Por éstas y otras cualidades, la daptomicina supone una buena alternativa a otros fármacos empleados en infecciones complicadas de la piel y los tejidos blandos, y en bacteriemias, por grampositivos
The development of mechanisms of resistance of many Gram-positive bacterial strains that cause complicated skin and soft tissue infections, as well as sepsis and bacteremia, has necessitated the search for new drugs that will improve treatment strategies. Daptomycin is a cyclic lipopeptide antibacterial that was launched for the treatment of complicated skin and soft tissue infections caused by Gram-positive organisms. The drug's mechanism of action is different from that of any other antibiotic. It binds to bacterial membranes and causes a rapid depolarization of membrane potential. This loss of membrane potential causes inhibition of protein, DNA and RNA synthesis, which results in bacterial cell death. The in vitro spectrum of activity of daptomycin encompasses most clinically relevant aerobic Gram-positive pathogenic bacteria. Compared to other antibiotics with a similar antibacterial spectrum, daptomycin does not cause nephrotoxicity. Taking these and other characteristics into consideration, daptomycin appears to be a good alternative to other drugs used in the treatment of complicated skin and soft tissue infections and in Gram-positive bacteremial infections