Antimicrobial Research Group, Division of Infectious Diseases, Federal University of São Paulo, São Paulo, Brazil.
Shock. 2013 May;39 Suppl 1:24-8. doi: 10.1097/SHK.0b013e31828faec0.
Inappropriate use of antimicrobial drugs is responsible for therapeutic failures, increased mortality rates, and the emergence of resistance. Antimicrobial activity is determined by intrinsic pharmacokinetics/pharmacodynamics concepts. In critically ill patients, an inappropriate dosing regimen can be caused by the inability of an antimicrobial drug to reach adequate concentrations at the infection site owing to alterations in the drug's pharmacokinetics caused by pathophysiological changes. Understanding these concepts and changes in PK-PD parameters that occur in intensive care unit patients is crucial for the optimization of antimicrobial therapy in these patients.
不适当使用抗菌药物会导致治疗失败、死亡率增加和耐药性的出现。抗菌活性取决于内在的药代动力学/药效学概念。在危重症患者中,由于病理生理变化导致药物的药代动力学发生改变,使抗菌药物无法在感染部位达到足够的浓度,从而导致给药方案不当。了解这些概念以及重症监护病房患者中 PK-PD 参数的变化,对于优化这些患者的抗菌治疗至关重要。