防治多重抗藥性細菌的後抗生素時代──單株抗體治療策略

Fighting multi-drug resistant bacteria in a post-antibiotic era: the promising strategy of antibacterial monoclonal antibodies

多重抗藥性細菌的嚴重性並未因COVID-19疫情停下腳步，儘管依據WHO指引，除非臨床懷疑有細菌感染，否則不建議對疑似或確診SARS-CoV-2輕症或肺炎患者常規給予抗生素治療，近期研究卻指出SARS-CoV-2患者的非必要抗生素治療比例，依舊居高不下。因此，無論是否面臨疫情威脅，抗生素抗藥性的沉默流行，依舊是亙久不變的議題。身處在後抗生素時代的我們，舉凡長期推廣合理使用抗生素、優化感染控制流程、開發新的抗菌藥劑與疫苗，都應納入抗菌工具箱的重要成員。其中疫苗及單株抗體的發展，這幾年隨著生物技術的進步及抗癌領域的發展，正逐漸受到重視。儘管在研究及臨床試驗的產品上已有不錯的進展，然而要於臨床上大量應用仍有需多挑戰，本文將闡述目前抗菌單株抗體的優勢、臨床試驗發展及未來挑戰，期待未來有更多工具來抵抗抗藥性細菌的感染，讓治療策略更有彈性。

The impact of COVID-19 on antimicrobial resistance has become an issue of interest because of inappropriate antibiotic use in patients infected with SARS-CoV-2 for suspected bacterial infections. Antimicrobial resistance is a silent pandemic with disastrous consequences. Under these circumstances, multi-drug resistant (MDR) bacterial nosocomial infections have induced a higher mortality rate in patients and have persistently spread in hospital environments. Therefore, infection control practices, antimicrobial stewardship, new antibiotics, or other approaches to antimicrobial agents are urgently needed. Monoclonal antibodies (mAbs) have recently been introduced as a promising therapeutic strategy for combating MDR bacteria. In this review, we present the development strategies and future perspectives for mAbs.