在接受长期间歇性脏替代疗法的危急病患者中,抗微生物药理学和剂量:系统性审查
Arvind Grewal1, Pierre Thabet2, Samuel Dubinsky3
1The Ottawa Hospital, Ottawa, Ontario, Canada.
Pharmacotherapy
|August 19, 2023
概括
本综述总结了长期间歇性脏替代疗法 (PIRRT) 期间的抗微生物药理学. 对一些药物做出了强有力的剂量建议,但对其他药物需要更多的研究.
科学领域:
- 药理学 药理学是指药理学的学科.
- 腎臟病學 (nephrology) 是一種醫學.
- 关键护理医学 关键护理医学
背景情况:
- 长期间歇性置换疗法 (PIRRT) 越来越多地用于ICU.
- 与其他RRT方式相比,PIRRT期间的抗菌剂量存在有限的指导.
- 了解抗微生物药理动力学 (PK) 和药理动力学 (PD) 对于有效治疗至关重要.
研究的目的:
- 系统地审查PIRRT.在严重病情的成年人中的抗微生物PK数据.
- 在PIRRT期间评估抗菌PK/PD现有证据的质量.
- 为PIRRT提出基于证据的抗微生物剂量建议.
主要方法:
- 在多个数据库中进行了系统的文献搜索.
- 包括在内的研究报告了PIRRT接受的重症成年人抗菌药物的PK和/或PD数据.
- 进行重复的质量评估,数据提取和PK/PD结果的合成.
主要成果:
- 包括39项涉及452名患者的研究,涵盖20种抗微生物药物.
- 最常被研究的是万科米辛,梅洛和皮佩拉西林/塔扎巴克坦.
- 强有力的证据支持了7种抗微生物药物的PK/PD数据,对9种抗微生物药物有强有力的剂量建议.
结论:
- 尽管总体证据质量较低,但对于近一半研究的抗微生物药物,强有力的剂量建议是可能的.
- 对于许多在PIRRT期间使用的抗微生物药物,仍然存在重大知识差距.
- 需要更高质量的研究,特别是人口PK研究,以改进剂量策略.
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