重症细菌感染的抗生素治疗：抑制商数与治疗结果的相关性

Antibiotic therapy for severe bacterial infections: correlation between the inhibitory quotient and outcome.

作者信息

Spanu Teresa, Santangelo Rosaria, Andreotti Felicita, Cascio Giuliana Lo, Velardi Giuseppe, Fadda Giovanni

机构信息

Department of Microbiology, Catholic University of the Sacred Heart, Largo F Vito 1, 00168 Rome, Italy.

出版信息

Int J Antimicrob Agents. 2004 Feb;23(2):120-8. doi: 10.1016/j.ijantimicag.2003.06.006.

DOI:10.1016/j.ijantimicag.2003.06.006

PMID:15013036

Abstract

In severe bacterial infections, treatment failure can occur even when the infecting organism has displayed in vitro susceptibility to the antibiotics used. Several pharmacokinetic-pharmacodynamic parameters show better correlation with therapeutic outcome than susceptibility results. This study was devised to assess the relation between the inhibitory quotient (IQ), i.e., the ratio of achievable antibiotic concentration at the infection site to the minimum inhibitory concentration for the infecting organism, and both clinical and bacteriological outcomes in 290 severe bacterial infections. Multivariate analysis showed that the IQ was a strong predictor of therapeutic outcome ( P< 0.001-0.002): values <4 predicted failure, and those >or=6 cure. This simple parameter could be routinely used to guide effective antibiotic therapy.

摘要

在严重细菌感染中，即便感染病原体在体外对所用抗生素显示出敏感性，治疗仍可能失败。一些药代动力学-药效学参数与治疗结果的相关性比药敏结果更好。本研究旨在评估抑制商（IQ），即感染部位可达到的抗生素浓度与感染病原体最低抑菌浓度之比，与290例严重细菌感染的临床和细菌学结果之间的关系。多变量分析表明，IQ是治疗结果的有力预测指标（P<0.001 - 0.002）：IQ值<4预示治疗失败，而≥6则预示治愈。这个简单的参数可常规用于指导有效的抗生素治疗。