Albany College of Pharmacy and Health Sciences, Albany, NY, USA.
Crit Care Clin. 2011 Jan;27(1):1-18. doi: 10.1016/j.ccc.2010.11.003.
This article reviews the principles of antimicrobial pharmacokinetics and pharmacodynamics in the context of the ICU for the most commonly used antibiotics. For therapy to truly be efficacious, the regimen must be effective against the organism, but not harmful to the patient. We review how optimization of chemotherapy requires a careful balancing of efficacy against toxicity when selecting dose and dose schedules. In addition, we discuss the importance of considering concentrations at the site of infection and how dose optimization can help suppress resistance emergence and preserve our antimicrobial armamentarium for the future. Finally, we examine combination chemotherapy and strategies for optimizing the administration of multiple agents.
本文回顾了 ICU 中最常用抗生素的抗菌药代动力学和药效学原则。为了使治疗真正有效，方案必须对病原体有效，但对患者无害。我们回顾了在选择剂量和剂量方案时，如何通过平衡疗效和毒性来优化化疗。此外，我们还讨论了考虑感染部位浓度以及如何通过优化剂量来帮助抑制耐药性出现并为未来保留我们的抗菌药物的重要性。最后，我们研究了联合化疗和优化多种药物给药的策略。
