临床指导方针之外的批判性评价对于腹腔内候群病的临床指导方针
Emilio Maseda1, Ignacio Martín-Loeches2,3, Rafael Zaragoza4
1Service of Anesthesia, Hospital Quirónsalud Valle del Henares, Av. de La Constitución, 249, 28850, Torrejón de Ardoz, Madrid, Spain. emilio.maseda@gmail.com.
Critical care (London, England)
|October 3, 2023
概括
腹腔内候群 (IAC) 治疗仍然具有挑战性,死亡率高. 脂质体安福特里辛B被提议作为一线选择,特别是在危急病患者中,等待进一步的临床试验.
科学领域:
- 传染性疾病 传染性疾病
- 临床药理学 临床药理学
- 关键护理医学 关键护理医学
背景情况:
- 腹腔内候群 (IAC) 是一个重大的临床挑战,其持续高的死亡率.
- 目前的抗真菌治疗方法在达到足够的腹腔药物度方面存在局限性,特别是在重症患者中.
研究的目的:
- 讨论腹腔内候群 (IAC) 的替代抗真菌策略.
- 建议IAC的治疗算法,考虑药物透率和患者特定因素.
- 在特定患者群体中提倡脂质体安二乙作为潜在的第一线治疗.
主要方法:
- 在IAC中对抗真菌药理动力学和药理动力学 (PK/PD) 的现有文献的审查.
- 药学动力学分析,以评估最佳剂量对于腹膜液透.
- 为IAC管理开发一个拟议的处理算法.
主要成果:
- 标准的回声素剂量可能不足以达到腹液中足够的药代动力学 (PK) 水平.
- 利波索姆二乙被建议作为第一线选择,用于患有败血症/败血性休克,先前抗真菌暴露或Candida glabrata感染的患者.
- 基于PK/PD的治疗证据有限,需要进一步调查.
结论:
- 在IAC中,迫切需要进行强大的临床试验和抗真菌耐药性监测.
- 个性化治疗方法和抗真菌管理对于优化结果至关重要.
- 在有进一步证据出现之前,脂质体安二 B 值得考虑作为一线治疗.
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