Glycopeptides.

Objectives: To review pharmacology, pharmacokinetic and therapeutic use of glycopeptides in intensive care units. Data sources: Extraction from Medline(R) database of French and English art icles on glycopeptides and search along with major review articles. Data selection: The collected articles were reviewed and selected according to their quality and originality. The more recent data were selected. Data synthesis: Glycopeptides are bactericidal antibiotics which are only a ctive against Gram positive species acting by inhibiting peptidoglycan synt hesis. They had been in clinical use for almost 30 years without high-level resistance underlining. For ten years, there have been disturbing reports of first, resistance to vancomycin in enterococcal species and more recentl y in strains of Staphylococcus aureus by complex and large mechanisms of ac tion. This new resistances may lead to a therapeutic impasse and a fatal is sue for infected patients. The only response to this situation is the respe ct of prescription rules and the careful use of antibiotics. Conclusion: Considering their spectrum, glycopeptides are an antibiotic fam ily which importance is fundamental to treat infected patients of intensive care units. Staff members of intensive care units are responsible for thei r good use. (C) 2000 Editions scientifiques et medicales Elsevier SAS.