Drexel University, 708 Mt. Pleasant Road, Bryn Mawr, Philadelphia, PA 19010, USA.
Infect Dis Clin North Am. 2009 Dec;23(4):791-815, vii. doi: 10.1016/j.idc.2009.06.008.
This article reviews pharmacodynamics of antibacterial drugs, which can be used to optimize treatment strategies, prevent emergence of resistance and rationalize the determination of antimicrobial susceptibility. Important pharmacodynamic concepts include the requirements for bactericidal therapy for endocarditis and meningitis, for synergistic combinations to treat enterococcal endocarditis or to shorten the course of antimicrobial therapy, for obtaining maximal plasma concentration/minimal inhibitory concentration (MIC) ratios that are greater than 10 or 24 hour-area under the plasma concentration curve (AUC)/MIC ratios that are greater than 100-125 for concentration-dependent agents against gram-negative bacilli and 25-35 against Streptococcus pneumoniae, and for obtaining percent of time that drug levels are greater than the MIC that is at least 40% to 50% of the dosing interval for time-dependent agents.
本文综述了抗菌药物的药效学，这有助于优化治疗策略、防止耐药性的出现，并使抗菌药物敏感性的确定更加合理。重要的药效学概念包括：治疗心内膜炎和脑膜炎时需要杀菌治疗；为了治疗肠球菌心内膜炎或缩短抗菌治疗疗程，需要联合使用具有协同作用的药物；为了使最大血浆浓度/最小抑菌浓度（MIC）比值大于 10 或 24 小时血浆浓度曲线下面积（AUC）/MIC 比值大于 100-125（浓度依赖性药物针对革兰氏阴性杆菌）和 25-35（针对肺炎链球菌），以及使药物浓度超过 MIC 的时间百分比至少为给药间隔的 40%-50%（时间依赖性药物）。
