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在重症患者中优化抗菌疗法,临床医生和研究人员必须知道的东西

Claire Roger¹, Despoina Koulenti², Emmanuel Novy³

¹UR-UM103 IMAGINE, Univ Montpellier, Division of Anesthesia and Critical Care, Pain and Emergency Medicine, Nîmes University Hospital, Montpellier, France.

Anaesthesia, critical care & pain medicine

|May 29, 2025

概括

在重症监护室 (ICU) 中优化抗生素剂量对败血症的生存至关重要. 了解患者生理学和使用持续输液和治疗药物监测 (TDM) 等策略可以改善结果.

科学领域:

关键护理医学关键护理医学
传染病传染病传染病
临床药理学临床药理学

背景情况:

败血症的治疗需要及时,适当的抗微生物药物管理和精确的剂量,以确保患者在重症监护病房 (ICU) 的生存.
与一般人群相比,抗生素的药理动力学 (PK) 和药理动力学 (PD) 在重症患者中发生显著变化.
了解这些病理生理变化对于优化抗生素治疗和达到治疗药物度至关重要.

研究的目的:

对重症患者的病理生理变化对抗菌剂剂量决定的影响进行审查.
为临床医生提供实际考虑,以优化ICU中的抗菌疗法.
探索面临的挑战和未来的研究领域,为重症患者提供最佳的抗微生物疗法.

主要方法:

关于重症患者抗菌PK/PD的当前文献的综述.
分析影响抗菌剂剂量的因素,包括器官功能障碍和体外疗法.
讨论持续输液和治疗药物监测 (TDM) 等策略.

主要成果:

危急病患者表现出改变的抗微生物PK/PD,需要个性化剂量.
持续输注β-乳糖胺可以改善PK/PD目标的实现和临床结果.
治疗药物监测 (TDM) 是首选的,但并不总是可用,需要依赖临床因素进行剂量调整.

结论:

在ICU中优化抗菌疗法需要对改变的PK/PD和个性化剂量策略有深入的了解.
持续输液和仔细考虑患者特异性因素是有效治疗的关键.
需要进行进一步的研究,以应对对重症患者抗菌剂剂量的现有挑战.

关键词:

抗生素抗生素是一种抗生素.剂量优化的优化在ICU中,医生会对患者进行治疗.在PK/PD中,PK/PD是最常见的.时间 TDM TDM

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