Garzón Javier R, Cuervo M Sonia, Gómez R Julio, Cortés Jorge A
Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia.
Rev Chilena Infectol. 2011 Dec;28(6):537-45. Epub 2012 Jan 5.
Febrile neutropenia is a serious complication of antineoplastic therapy and it is more commonly found in hematologic patients, associated with high mortality rates. Inadequate tissue concentration of antimicrobials has been described as a cause of therapeutic failure which also has been related to a low interstitial concentration for hydrophilic antibiotics. In critically ill patients it may occur an accumulation of compartmental fluids which can be related to an increase in the distribution volume or changes in clearance of antimicrobials. Pharmacokinetic and pharmacodynamic parameters of antimicrobials are reviewed, which can be used as a tool to optimize the efficacy of antimicrobial therapy in order to avoid failures and resistance selection.
发热性中性粒细胞减少是抗肿瘤治疗的严重并发症,在血液学患者中更为常见,死亡率较高。抗菌药物组织浓度不足被认为是治疗失败的原因,这也与亲水性抗生素的间质浓度低有关。在重症患者中,可能会出现隔室液体积聚,这可能与分布容积增加或抗菌药物清除率变化有关。本文综述了抗菌药物的药代动力学和药效学参数,这些参数可作为优化抗菌治疗疗效的工具,以避免治疗失败和耐药性选择。