Department of Pharmacy Services and Clinical Pharmacy, Michigan Medicine, Ann Arbor, Michigan, USA.
Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan, USA.
Pediatr Pulmonol. 2021 Dec;56(12):3634-3643. doi: 10.1002/ppul.25441. Epub 2021 May 13.
Aminoglycosides are commonly used for the treatment of Pseudomonas aeruginosa (PsA) in the setting of acute pulmonary exacerbations (PEx) in pediatric patients with cystic fibrosis (CF). There are controversies and practice differences between institutions related to aminoglycoside dosing and monitoring strategies. The purpose of this review article is to summarize the currently available literature and identify gaps in the literature related to pharmacokinetic parameter goals, aminoglycoside dosing strategies, and methods for monitoring serum aminoglycoside concentrations for treatment of PsA in CF PEx, and throughout will discuss anticipated changes with the increasing availability of highly effective CF transmembrane conductance regulator modulators. This review focuses on tobramycin, as it is the most commonly used aminoglycoside in CF PEx, and will briefly discuss special circumstances surrounding use of amikacin and gentamicin.
氨基糖苷类药物常用于治疗囊性纤维化（CF）患儿急性肺部加重（PEx）时的铜绿假单胞菌（PsA）。在氨基糖苷类药物剂量和监测策略方面，各机构之间存在争议和实践差异。本文的目的是总结目前可获得的文献，并确定与治疗 CF PEx 中 PsA 的药代动力学参数目标、氨基糖苷类药物剂量策略以及监测血清氨基糖苷类浓度的方法相关的文献中的空白，并讨论随着越来越多的高效 CF 跨膜电导调节剂调节剂的出现，预期会发生哪些变化。本综述重点介绍了妥布霉素，因为它是 CF PEx 中最常用的氨基糖苷类药物，并且还将简要讨论围绕阿米卡星和庆大霉素使用的特殊情况。
