Velissaris Dimitrios, Karamouzos Vasilios, Marangos Markos, Pierrakos Charalampos, Karanikolas Menelaos
Internal Medicine Department, University Hospital of Patras, Rion 26500, Greece.
Intensive Care Department, Brugmann University Hospital, Brussels 1030, Belgium.
J Clin Med Res. 2014 Aug;6(4):227-33. doi: 10.14740/jocmr1858w. Epub 2014 May 22.
The objective of the paper is to review the literature and provide recommendations for use of aminoglycoside antibiotics in critically ill obese patients. Literature search in PubMed for all articles on the use of aminoglycosides in critically ill obese patients was conducted, and all articles related to pharmacokinetics in obesity were reviewed. Bibliographies of all searched manuscripts were also reviewed in an attempt to find additional references. Although aminoglycoside pharmacokinetics have been described in detail, data on aminoglycoside use and appropriate dose modification in critically ill obese patients are very limited. Knowledge on aminoglycoside pharmacokinetics and use in critically ill obese patients is incomplete. Pathophysiologic changes in obesity can result in sub- or supra-therapeutic aminoglycoside plasma concentrations, especially in the presence of sepsis. Rigorous clinical studies are needed to establish aminoglycoside dosing guidelines in critically ill obese patients with sepsis.
本文的目的是回顾文献，并为危重症肥胖患者使用氨基糖苷类抗生素提供建议。我们在PubMed上检索了所有关于危重症肥胖患者使用氨基糖苷类药物的文章，并对所有与肥胖患者药代动力学相关的文章进行了综述。我们还查阅了所有检索到的手稿的参考文献，试图找到更多的参考文献。尽管氨基糖苷类药物的药代动力学已经有了详细的描述，但关于危重症肥胖患者使用氨基糖苷类药物及适当剂量调整的数据非常有限。关于氨基糖苷类药物在危重症肥胖患者中的药代动力学和使用的知识并不完整。肥胖患者的病理生理变化可能导致氨基糖苷类药物血浆浓度低于或高于治疗水平，尤其是在存在脓毒症的情况下。需要进行严格的临床研究，以建立危重症肥胖脓毒症患者的氨基糖苷类药物给药指南。
