Internal Medicine Department, Beaujon Hospital, APHP and University Paris Diderot, Sorbonne Paris Cité, Paris, France.
Clin Pharmacokinet. 2013 Oct;52(10):869-83. doi: 10.1007/s40262-013-0086-1.
Patients with cancer or hematologic diseases are particularly at risk of infection leading to high morbidity, mortality and costs. Extensive data show that optimization of the administration of antimicrobials according to their pharmacokinetic and pharmacodynamic parameters improves clinical outcome. Evidence is growing that when pharmacokinetic and pharmacodynamic parameters are used to target not only clinical cure but also eradication, the selection resistance is also contained. This is of particular importance in patients with neutropenia in whom increasing rates of drug-resistant Gram-negative bacteria have been reported, particularly Pseudomonas aeruginosa. Based on experimental and clinical studies, pharmacokinetic and pharmacodynamic parameters are discussed in this review for each antibiotic used in febrile neutropenia in order to help physicians improve dosing and optimization of antimicrobial agents.
患有癌症或血液疾病的患者尤其容易感染，导致发病率、死亡率和治疗费用高。大量数据表明，根据抗菌药物的药代动力学和药效学参数优化给药可以改善临床结局。越来越多的证据表明，当药代动力学和药效学参数不仅用于临床治愈，而且用于根除时，耐药性的选择也会受到抑制。这在中性粒细胞减少症患者中尤为重要，因为已有报道称，中性粒细胞减少症患者中性粒细胞减少症患者中耐药革兰氏阴性菌（尤其是铜绿假单胞菌）的发生率不断上升。基于实验和临床研究，本文对发热性中性粒细胞减少症中使用的每种抗生素的药代动力学和药效学参数进行了讨论，以帮助医生改善抗菌药物的给药和优化。
