Parker S E, Davey P G
Department of Clinical Pharmacology, Ninewells Hospital and Medical School, Dundee, Scotland.
Pharmacoeconomics. 1995 May;7(5):393-402. doi: 10.2165/00019053-199507050-00004.
A fuller understanding of the pharmacodynamics of aminoglycoside antibiotics now exists compared with when they were introduced. Recent findings have shown that once-daily dosage regimens of aminoglycosides are as effective as bd or tid regimens in the treatment of Gram-negative sepsis. However, radical changes in dosage frequency based on this knowledge are resisted by some physicians because of fears about the peak concentration toxicity of aminoglycosides. These fears have been shown to be misplaced. The delay in the translation of research findings into practice may be attributable to the sheer quantity of medical literature and the limited time that clinicians have available to read it. Because healthcare resources are finite, physicians are increasingly becoming aware of the need to use drug therapy in the most cost-effective way. An important component of aminoglycoside therapy that may persuade clinicians to change their practice is the organised consideration of the various costs associated with different administration regimens. This review examines the source of those costs, and endorses once-daily dosage of aminoglycosides from both an economic and practical viewpoint.
与氨基糖苷类抗生素刚问世时相比，如今人们对其药效学有了更全面的认识。最近的研究结果表明，氨基糖苷类抗生素每日一次的给药方案在治疗革兰氏阴性菌败血症方面与每日两次或三次的给药方案效果相同。然而，由于担心氨基糖苷类抗生素的峰值浓度毒性，一些医生抵制基于这一认识而对给药频率进行的彻底改变。事实证明，这些担忧是没有根据的。研究结果转化为实际应用的延迟可能归因于医学文献的数量庞大以及临床医生可用于阅读的时间有限。由于医疗资源有限，医生越来越意识到需要以最具成本效益的方式使用药物治疗。氨基糖苷类药物治疗中一个可能说服临床医生改变其做法的重要因素是对与不同给药方案相关的各种成本进行有条理的考量。本综述探讨了这些成本的来源，并从经济和实际角度认可了氨基糖苷类抗生素每日一次的给药方式。
