Nichols Kristen R, Israel Emily N, Thomas Christopher A, Knoderer Chad A
Butler University, Indianapolis, IN, USA Indiana University Health, Indianapolis, IN, USA Indiana University School of Medicine, Indianapolis, IN, USA
Indiana University Health, Indianapolis, IN, USA Purdue University, Indianapolis and West Lafayette, IN, USA.
Ann Pharmacother. 2016 May;50(5):423-7. doi: 10.1177/1060028016635660. Epub 2016 Feb 25.
The American Heart Association recently published an updated scientific statement on the management of infective endocarditis in childhood. The recommendations included for vancomycin, aminoglycoside, and β-lactam dosing and monitoring are based primarily on expert opinion and do not consider available evidence for dose optimization based on pharmacokinetic and pharmacodynamic principles in pediatric patients. This is concerning because even when clinically necessary, some practitioners may be hesitant to deviate from guideline-recommended doses. In this perspective, we highlight potential areas for improvement in the statement-recommended doses and summarize evidence supporting antibiotic dosing optimization. The addition of a pediatric clinical pharmacist with expertise in antibiotic dosing to the panel would be beneficial for future updates.
美国心脏协会最近发表了一份关于儿童感染性心内膜炎管理的最新科学声明。关于万古霉素、氨基糖苷类和β-内酰胺类药物给药及监测的建议主要基于专家意见，未考虑根据儿科患者的药代动力学和药效学原理进行剂量优化的现有证据。这令人担忧，因为即使在临床必要时，一些从业者可能也会犹豫是否偏离指南推荐的剂量。从这个角度来看，我们强调了声明推荐剂量中潜在的改进领域，并总结了支持抗生素剂量优化的证据。在专家小组中增加一名在抗生素给药方面有专业知识的儿科临床药师将有利于未来的更新。
