Soto Dagoberto, Silva Camila, Andresen V Max, Soto Natalia, Wong Kwok-Yin, Andresen Max
Rev Med Chil. 2015 Aug;143(8):1050-7. doi: 10.4067/S0034-98872015000800013.
The pharmacokinetics of antibiotics, especially in severely ill patients, may be profoundly altered due to multiple pathophysiological changes. Recent studies have shown that empiric dosing recommendations for ICU patients are inadequate to effectively treat a broad range of susceptible organisms and need to be reconsidered. Therapeutic drug monitoring (TDM) is an important mean for optimizing drug utilization and doses for the purpose of improving the clinical effectiveness. However, it is very challenging to quantify plasma antibiotic concentrations in clinical situations as a routine practice, because of the high costs and complexities associated with advanced instrumental techniques. Currently there are not routine and low cost methods to determine the presence and concentration of β-lactam antibiotics in plasma patients in a clinical setup. Indeed, such analytical methods are based on chromatographic techniques mainly used in research. Here we describe and comment different techniques, focusing on our preliminary experience using biosensors.
抗生素的药代动力学，尤其是在重症患者中，可能会因多种病理生理变化而发生深刻改变。最近的研究表明，针对重症监护病房（ICU）患者的经验性给药建议不足以有效治疗多种易感病原体，需要重新考虑。治疗药物监测（TDM）是优化药物使用和剂量以提高临床疗效的重要手段。然而，在临床实践中常规定量血浆抗生素浓度极具挑战性，因为先进仪器技术成本高昂且操作复杂。目前在临床环境中，尚无常规且低成本的方法来测定血浆中β-内酰胺类抗生素的存在及浓度。实际上，此类分析方法主要基于用于研究的色谱技术。在此，我们描述并评论不同技术，重点介绍我们使用生物传感器的初步经验。
