Dudley M N, Ambrose P G
Microcide Pharmaceuticals Inc., 850 Maude Ave., Mountain View, CA 94043, USA.
Curr Opin Microbiol. 2000 Oct;3(5):515-21. doi: 10.1016/s1369-5274(00)00132-6.
Considerable advancements have been made in providing informative, relevant interpretations of the results of antimicrobial susceptibility tests to clinicians, clinical microbiologists, epidemiologists, and researchers. At the same time, the science of pharmacokinetics has flourished, and the importance of drug exposure in vivo on outcome is now recognized by researchers and clinicians alike. More recently, pharmacokinetic and quantitative measures of antimicrobial susceptibility have been integrated using pharmacokinetic-pharmacodynamic (PK-PD) models to forecast clinical and microbiological outcomes. Stochastic methods utilizing patient population pharmacokinetics, target organism minimum inhibitory concentration (MIC) distributions, and PK-PD targets from non-clinical models of infection or clinical data have established a new paradigm for determining in vitro susceptibility breakpoints and selection of empirical therapy in clinical practice. Given the increasing problem of antimicrobial resistance, these new tools are valuable additions for clinicians, researchers, and regulatory authorities.
在为临床医生、临床微生物学家、流行病学家和研究人员提供有关抗菌药物敏感性试验结果的信息丰富且相关的解释方面，已经取得了相当大的进展。与此同时，药代动力学科学蓬勃发展，体内药物暴露对治疗结果的重要性现在已得到研究人员和临床医生的一致认可。最近，已使用药代动力学-药效学（PK-PD）模型将抗菌药物敏感性的药代动力学和定量测量方法结合起来，以预测临床和微生物学结果。利用患者群体药代动力学、目标微生物最低抑菌浓度（MIC）分布以及来自非临床感染模型或临床数据的PK-PD目标的随机方法，为确定体外药敏折点和临床实践中经验性治疗的选择建立了新的范例。鉴于抗菌药物耐药性问题日益严重，这些新工具对临床医生、研究人员和监管机构来说都是宝贵的补充。
