Xenleta, as a type of Truncated Pleurotus ostreatus antibiotic, is mainly used for the treatment of specific bacterial infections. It is necessary to strictly control the indications and pay attention to liver function monitoring, drug interactions, and medication risks for special populations. Its use should follow the principle of individualization, with a focus on the impact on the cardiovascular system and the prevention of allergic reactions.

1. Scope of indications

(1) Community acquired pneumonia

Suitable for the treatment of community-acquired bacterial pneumonia (CABP) caused by sensitive bacteria such as Streptococcus pneumoniae and Staphylococcus aureus in adults over 18 years old.

(2) Antibiotic resistant bacterial infection

Effective against methicillin-resistant Staphylococcus aureus (MSSA), Streptococcus pneumoniae, and other Gram positive bacteria, including some multidrug-resistant strains.

2. Medication precautions

(1) Basic assessment

Before medication, it is necessary to complete electrocardiogram and liver function tests to confirm the absence of QT interval prolongation and severe liver injury. Electrolyte disorders need to be corrected first.

(2) Medication regimen

Intravenous infusion should be controlled at a rate not exceeding 250ml/h, and oral preparations should avoid high-fat diets. The treatment usually takes 5-7 days and needs to be completed throughout the entire process.

3. Medication for special populations

(1) Liver dysfunction

Half the dose for Child Pugh C patients and monitor transaminase levels monthly during treatment. Continuous elevation of liver enzymes requires discontinuation of medication.

(2) Pregnancy and lactation

Pregnant women should only use it when the benefits outweigh the risks, and feeding should be suspended during lactation. Women of childbearing age need to use contraception from the time of medication until 2 days after discontinuation.

4. Drug interactions

(1) CYP3A4 impact

Avoid using potent CYP3A4 inducers/inhibitors in combination. The use of warfarin requires strengthened INR monitoring.

(2) QT prolongation drugs

It is prohibited to use QT prolonging drugs such as fluoroquinolones and tricyclic antidepressants in combination, as it may induce apical torsion ventricular tachycardia.

5. Prevention of adverse reactions

(1) Allergic reactions

If rash or difficulty breathing occurs during medication, the medication should be stopped immediately. Individuals with a history of beta lactam allergy should use with caution.

(2) Clostridium difficile infection

Long term use may damage the gut microbiota. Diarrhea patients need to be tested for Clostridium difficile toxin and receive targeted treatment after diagnosis.