Lortholary Olivier, Lefort Agnès, Tod Michel, Chomat Anne-Marie, Darras-Joly Clémence, Cordonnier Catherine
Université Paris Descartes, Department of Infectious and Tropical Diseases, Centre d'Infectiologie Necker-Pasteur, Hôpital Necker-Enfants Malades, Paris, France.
Lancet Infect Dis. 2008 Oct;8(10):612-20. doi: 10.1016/S1473-3099(08)70228-7.
We review experimental and clinical data on the pharmacokinetics and pharmacodynamics of antibacterial drugs in febrile neutropenic hosts. Since major pharmacokinetic changes have been reported for various classes of antibiotics in these patients, we advocate the need for adequate initial dosing regimens in all cases. Monitoring drug serum concentrations is mandatory for aminoglycosides and glycopeptides, and special attention should be paid to the dosing frequency of the short half-life beta-lactams to optimise the management of febrile neutropenia, especially in patients with severe sepsis.
我们回顾了关于抗菌药物在发热性中性粒细胞减少宿主中的药代动力学和药效学的实验及临床数据。由于已报道这些患者中各类抗生素存在主要的药代动力学变化，我们主张在所有情况下都需要适当的初始给药方案。对于氨基糖苷类和糖肽类药物，监测药物血清浓度是必需的，并且应特别关注短半衰期β-内酰胺类药物的给药频率，以优化发热性中性粒细胞减少症的治疗，尤其是在严重脓毒症患者中。
