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成人金黄色葡萄球菌菌血症的最佳药物治疗。

Optimal drug therapy for Staphylococcus aureus bacteraemia in adults.

机构信息

Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory.

Herston Infectious Diseases Institute, Metro North Health, Brisbane, Queensland.

出版信息

Curr Opin Crit Care. 2023 Oct 1;29(5):446-456. doi: 10.1097/MCC.0000000000001072. Epub 2023 Jul 27.

Abstract

PURPOSE OF REVIEW

Staphylococcus aureus is a significant human pathogen, causing a variety of infections, from skin and soft tissue infections to endocarditis, bone and joint infections and deep tissue abscesses. Mortality from S. aureus bacteraemia remains high, without major therapeutic advances in recent decades.

RECENT FINDINGS

In recent years, optimized dosing of antibiotics is increasingly being recognized as a cornerstone of management for severe infections including S. aureus bacteraemia. This comprehensive review details the pharmacokinetics/pharmacodynamics (PK/PD) targets for commonly used antistaphylococcal antibiotics and the doses predicted to achieve them in clinical practice. Recent advances in dosing of teicoplanin and use of cefazolin in CNS infections and findings from combination therapy studies are discussed. Drug exposure relationships related to toxicity are also detailed.

SUMMARY

This review details the different PK/PD targets for drugs used to treat S. aureus bacteraemia and how to apply them in various scenarios. The drug doses that achieve them, and the risks of toxicity are also provided.

摘要

目的综述

金黄色葡萄球菌是一种重要的人类病原体,可引起多种感染,从皮肤和软组织感染到心内膜炎、骨和关节感染以及深部组织脓肿。金黄色葡萄球菌菌血症的死亡率仍然很高,近几十年来没有重大的治疗进展。

最近的发现

近年来,越来越多的人认识到优化抗生素剂量是严重感染(包括金黄色葡萄球菌菌血症)管理的基石。这篇全面的综述详细介绍了常用抗葡萄球菌抗生素的药代动力学/药效学(PK/PD)目标以及在临床实践中预测达到这些目标的剂量。讨论了替考拉宁剂量的最新进展以及头孢唑林在中枢神经系统感染中的应用,以及联合治疗研究的结果。还详细介绍了与毒性相关的药物暴露关系。

总结

本综述详细介绍了用于治疗金黄色葡萄球菌菌血症的药物的不同 PK/PD 目标,以及如何在各种情况下应用这些目标。还提供了达到这些目标的药物剂量和毒性风险。

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