Beck S, Wicha S G, Kloft C, Kees M G
Klinik und Poliklinik für Anästhesiologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg-Eppendorf, Deutschland.
Anaesthesist. 2014 Oct;63(10):775-82. doi: 10.1007/s00101-014-2369-9.
Antibiotic agents are crucial pillars in intensive care medicine and must be used rationally and sensibly. In the case of critically ill patients optimal dosing with respect to pharmacokinetic and pharmacodynamic principles (PK/PD) can be vital. Preclinical results demonstrated important differences between antibiotic classes and gave rise to differing clinical dosing strategies, e.g. high dose once daily regimens for aminoglycosides or extended/continuous infusion of betalactams. Critically ill patients with altered pharmacokinetic parameters and infections by pathogens with low susceptibility are most likely to benefit from PK/PD-guided therapy.
抗生素药物是重症监护医学的关键支柱，必须合理且明智地使用。对于重症患者，根据药代动力学和药效学原理（PK/PD）进行优化给药可能至关重要。临床前结果表明不同抗生素类别之间存在重要差异，并产生了不同的临床给药策略，例如氨基糖苷类药物的高剂量每日一次给药方案或β-内酰胺类药物的延长/持续输注。药代动力学参数改变且感染低敏感性病原体的重症患者最有可能从PK/PD指导的治疗中获益。
