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[持续和间歇性肾脏替代疗法对脓毒症重症患者抗生素治疗的影响——基于万古霉素和庆大霉素治疗的实践观点]

[An effect of continuous and intermittent renal replacement therapy on antibiotic treatment in critically ill patients with sepsis - a practice-based perspective of vancomycin and gentamycin therapies].

作者信息

Petejová N, Martínek A, Zahálková J, Duricová J, Plášek J, Valkovský I, Grundmann M, Kacířová I

机构信息

Interní klinika Lékarské fakulty OU a FN Ostrava.

出版信息

Vnitr Lek. 2012 Jun;58(6):448-54.

Abstract

Sepsis and septic shock are common cause of hospitalisation in intensive care unit. Acute kidney injury is an accompanying manifestation of sepsis/septic shock leading to worsening of morbidity and also mortality and requiring use of intermittent or continual renal replacement therapy. Life saving effect is attributed to early and effective antibiotic therapy. Therapeutic drug monitoring and do-sage adjustment is important for successful treatment. Despite therapeutic drug monitoring of both antibiotic agents vankomycin and gentamicin the treatment still rises many questions about the convenient use in septic patients due to their nephrotoxicity.

摘要

脓毒症和脓毒性休克是重症监护病房住院治疗的常见原因。急性肾损伤是脓毒症/脓毒性休克的一种伴随表现,会导致发病率和死亡率上升,需要使用间歇性或连续性肾脏替代治疗。挽救生命的效果归因于早期有效的抗生素治疗。治疗药物监测和剂量调整对于成功治疗很重要。尽管对万古霉素和庆大霉素这两种抗生素进行了治疗药物监测,但由于它们的肾毒性,在脓毒症患者中的便捷使用仍存在许多问题。

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