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β-内酰胺类抗生素在脓毒症患者中延长输注的获益:个人观点。

Benefits of prolonged infusion of beta-lactam antibiotics in patients with sepsis: personal perspectives.

机构信息

School of Medicine, Democritus University of Thrace , Alexandroupolis, Greece.

Alfa Institute of Biomedical Sciences (AIBS) , Athens, Greece.

出版信息

Expert Rev Anti Infect Ther. 2020 Oct;18(10):957-966. doi: 10.1080/14787210.2020.1776113. Epub 2020 Jun 21.

Abstract

INTRODUCTION

In the current era of relatively scarce antibiotic production and significant levels of antimicrobial resistance, optimization of pharmacokinetics and pharmacodynamics of antibiotic therapy is mandatory. Prolonged infusion of beta-lactam antibiotics in comparison to the intermittent infusion has the theoretical advantage of better patient outcomes. Apparently, conflicting data in the literature possibly underestimate the benefits of prolonged infusion of antibiotic treatment.

AREAS COVERED

We provide our perspective on the subject based on our experience and by critically evaluating literature data.

EXPERT OPINION COMMENTARY

In our opinion, the available data are suggestive of the beneficial role of prolonged infusion of beta-lactams in regard to piperacillin/tazobactam and carbapenems after administering a loading dose. While more data from randomized controlled trials are necessary to solidify or negate the evident benefits of prolonged infusion of the aforementioned antibiotics, clinicians should strongly consider this mode of administration of relevant antibiotics, especially in patients with severe infections.

摘要

简介

在当前抗生素产量相对较少且抗菌药物耐药性水平显著的时代,优化抗生素治疗的药代动力学和药效学是强制性的。与间歇性输注相比,β-内酰胺类抗生素的长时间输注具有更好的患者转归的理论优势。然而,文献中的矛盾数据可能低估了延长抗生素治疗输注的益处。

涵盖领域

我们根据经验并通过批判性地评估文献数据,提供了我们对该主题的看法。

专家意见评论

在我们看来,现有数据表明,在给予负荷剂量后,延长输注哌拉西林/他唑巴坦和碳青霉烯类药物的β-内酰胺类药物具有有益作用。虽然需要更多来自随机对照试验的数据来证实或否定上述抗生素延长输注的明显益处,但临床医生应强烈考虑这种相关抗生素的给药方式,尤其是在严重感染患者中。

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