Carcelero Esther, Soy Dolors
Servicio de Farmacia, Hospital Clínic Barcelona, Barcelona, España.
Enferm Infecc Microbiol Clin. 2012 May;30(5):249-56. doi: 10.1016/j.eimc.2011.09.013. Epub 2011 Nov 29.
Acute renal failure is frequent in critically ill patients. In those patients who need renal replacement therapy, continuous techniques are an alternative to intermittent haemodialysis. Critically ill patients often have an infection, which can lead to sepsis and renal failure. An early and adequate antibiotic treatment at correct dosage is extremely important. Methicillin resistant Staphylococcus aureus (MRSA) is a frequent nosocomial pathogen that causes a high rate of morbidity and mortality in critically ill patients. Many antibiotics are easily removed by continuous renal replacement therapies (CRRT) leading to a high risk of under dosing and therapeutic failure or resistance breakthrough. The objective of this review is to assess the clinical evidence on the pharmacokinetics and dosage recommendations of the main antibiotic groups used in MRSA treatment in patients treated with CRRT.
急性肾衰竭在重症患者中很常见。对于那些需要肾脏替代治疗的患者，连续性技术可作为间歇性血液透析的替代方法。重症患者常发生感染，这可能导致脓毒症和肾衰竭。早期给予正确剂量的充分抗生素治疗极为重要。耐甲氧西林金黄色葡萄球菌（MRSA）是一种常见的医院病原体，在重症患者中导致高发病率和死亡率。许多抗生素可通过连续性肾脏替代治疗（CRRT）轻易清除，导致给药不足、治疗失败或耐药突破的高风险。本综述的目的是评估在接受CRRT治疗的患者中，用于治疗MRSA的主要抗生素组的药代动力学和剂量推荐的临床证据。
