Mazzei Teresita, Novelli Andrea, Arrigucci Silvia
Dipartimento di Farmacologia Preclinica e Clinica, Università degli Studi di Firenze, Italy.
Infez Med. 2009 Sep;17 Suppl 4:37-57.
The pharmacodynamic and pharmacokinetic characteristics of antimicrobial agents are the two fundamental pharmacological components which provide a rational for the choice of therapy for skin and skin structure infections, and especially serious infections. The most important PK-PD parameters are well known which can potentiate therapeutic efficacy. Antimicrobial agents ca be subdivided into categories based on whether their activity is dependent on concentration or exposure time. Therefore, a correct dosing regimen for the time-dependent molecules (i.e. beta-lactams, linezolid, tigecycline) should prolong the maximum exposure time to maintain serum levels over the minimum inhibitory concentration (MIC). The concentration-dependent molecules, on the other hand, which include aminoglycosides and fluoroquinolones, should be given in order to reach maximum concentrations, since they are bactericidal in direct proportion to their concentrations and possess a prolonged post-antibiotic effect.
抗菌药物的药效学和药代动力学特性是两个基本的药理学组成部分,它们为皮肤及皮肤结构感染,尤其是严重感染的治疗选择提供了依据。最重要的药代动力学-药效学参数是众所周知的,这些参数可以增强治疗效果。抗菌药物可根据其活性是取决于浓度还是暴露时间进行分类。因此,对于时间依赖性分子(即β-内酰胺类、利奈唑胺、替加环素),正确的给药方案应延长最大暴露时间,以维持血清水平高于最低抑菌浓度(MIC)。另一方面,浓度依赖性分子,包括氨基糖苷类和氟喹诺酮类,应给予足够剂量以达到最大浓度,因为它们的杀菌作用与其浓度成正比,并且具有较长的抗生素后效应。