Morita Kunihiko
Department of Clinical Pharmaceutics, Doshisha Women's College of Liberal Arts, Kyotanabe, Kyoto, Japan.
Yakugaku Zasshi. 2011;131(10):1407-13. doi: 10.1248/yakushi.131.1407.
Recently, the pharmacokinetic (PK)-pharmacodynamic (PD) theory draws attention in the therapy of the infectious disease. Although the theory was only introduced into the field of antimicrobial therapy several years ago, the foundation was in the individualization of administering design by therapeutic drug monitoring (TDM) begun 30 years ago. Although, the main purpose of TDM that had been performed so far was assumption of the evasion of the side effects caused with antimicrobials, it is difficult to say that it has been used as a tool to improve the efficacies. Furthermore, although the information described in the package inserts of antimicrobials must be important grounds to use the agents properly, it was recently recognized that there were pitfalls in PK-PD region. In this review, the following three items are described; 1) problem of dosage regimen described in package insert of antimicrobials, such as aminoglycosides and vancomycin in our country, and findings accumulated through their TDM; 2) strategy for proper use of antimicrobials based on PK-PD theory; 3) finally, the role of the pharmacist expected in the area of the infectious disease treatment.
最近，药代动力学（PK）-药效学（PD）理论在传染病治疗中受到关注。尽管该理论几年前才被引入抗菌治疗领域，但其基础是30年前开始的通过治疗药物监测（TDM）进行个体化给药设计。然而，迄今为止进行TDM的主要目的是推测避免抗菌药物引起的副作用，很难说它已被用作提高疗效的工具。此外，尽管抗菌药物包装说明书中描述的信息一定是正确使用药物的重要依据，但最近人们认识到在PK-PD领域存在一些缺陷。在本综述中，描述了以下三个方面：1）我国抗菌药物（如氨基糖苷类和万古霉素）包装说明书中描述的给药方案问题，以及通过其TDM积累的研究结果；2）基于PK-PD理论正确使用抗菌药物的策略；3）最后，药剂师在传染病治疗领域预期发挥的作用。
