在接受抗微生物治疗的成年患者中增加清量的定义,患病率和危险因素:范围审查
Hasan Memiş1, Ahmet Çakır2, Aysel Pehlivanlı3,4
1University of Health Sciences Konya Beyhekim Training and Research Hospital, Konya, Türkiye.
Infectious diseases & clinical microbiology
|July 14, 2025
概括
增加清除 (ARC) 影响患者的药物水平. 这次审查发现ARC患病率各不相同,并确定了风险因素,强调需要调整抗微生物剂量策略.
科学领域:
- 药理学 药理学是指药理学的学科.
- 腎臟病學 (nephrology) 是一種醫學專業.
- 传染性疾病 传染性疾病
背景情况:
- 增加脏清除 (ARC),以快速药物消除为特征,可以通过引起次治疗性药物度来损害抗微生物药物的有效性.
- 了解ARC对于优化特定成年患者群体的抗菌疗法至关重要.
研究的目的:
- 在接受抗菌药物治疗的成年患者中对ARC进行综合证据的范围审查.
- 为了确定患病率,确定风险因素,并评估ARC对达到治疗药物水平的影响.
- 确定研究缺陷,并提出对ARC患者抗菌剂的剂量建议.
主要方法:
- 该审查遵循PRISMA-ScR指导方针,分析了2019-2023年间发表的Web of Science,PubMed和Scopus的研究.
- 包括的研究集中在ARC和成年患者的抗菌疗法;非英语,评论和非人类文章被排除在外.
- 数据提取包括研究细节,患者人口统计,ARC定义,患病率,功能评估方法和结果.
主要成果:
- 在492篇确定文章中,47篇涉及6193名患者的研究符合纳入标准.
- ARC的患病率差异很大 (3.3%-100%),可克克罗夫特-高尔特方程最常用于肌素清除率计算 (66%).
- 在8.5%的研究中发现了ARC的危险因素;糖是研究最多的药物类别 (31.9%),55.3%的研究建议使用更高剂量或长时间输注.
结论:
- 特定的抗微生物药物类别,如β-乳酸盐,线化物,糖和氨基糖化物,可能需要调整剂量或改变ARC患者的服用方式.
- 进一步的研究至关重要,以阐明ARC对患者结果的临床影响,并完善抗菌剂剂量策略.
相关概念视频
01:06Renal Drug Clearance: Overview
Renal clearance is a crucial parameter in pharmacokinetics that quantifies the rate at which the kidneys excrete a drug. It represents a constant fraction of the central volume of distribution containing the drug that the kidney eliminates per unit of time.
Renal clearance can be calculated using different methods. One approach is to divide the urinary drug excretion rate by the plasma drug concentration. This method directly measures renal clearance, indicating the kidneys' efficiency in...
Renal clearance can be calculated using different methods. One approach is to divide the urinary drug excretion rate by the plasma drug concentration. This method directly measures renal clearance, indicating the kidneys' efficiency in...
01:08Renal Drug Clearance: Comparison Between Renal Excretion Methods
Renal clearance is a critical parameter encompassing kidney filtration, secretion, and reabsorption processes. It is calculated using a specific equation to determine the rate at which the kidneys clear a drug.
Renal clearance is often associated with the renal glomerular filtration rate (GFR), which represents the rate at which plasma is filtered through the glomeruli in the kidney. When drug reabsorption is minimal and there is no active secretion, renal clearance is closely related to the...
Renal clearance is often associated with the renal glomerular filtration rate (GFR), which represents the rate at which plasma is filtered through the glomeruli in the kidney. When drug reabsorption is minimal and there is no active secretion, renal clearance is closely related to the...
01:31Factors Affecting Renal Clearance: Drug's Physicochemical Properties and Plasma Levels
Renal clearance of a drug is influenced by various factors, including its physicochemical properties and plasma levels. These factors play a significant role in determining how efficiently the kidneys eliminate a drug.
One important factor is the drug's molecular size. The kidneys readily excrete smaller molecules below 300 Daltons (Da). On the other hand, molecules weighing between 300 and 500 Da are excreted through both urine and bile. Larger molecules above 500 Da tend to be excreted less...
One important factor is the drug's molecular size. The kidneys readily excrete smaller molecules below 300 Daltons (Da). On the other hand, molecules weighing between 300 and 500 Da are excreted through both urine and bile. Larger molecules above 500 Da tend to be excreted less...
01:09Factors Affecting Renal Clearance: Drug Distribution and Drug Interactions
Renal clearance plays a pivotal role in drug elimination from the body and can be influenced by drug distribution and interactions. Understanding these factors is crucial in pharmacology as they impact the effectiveness and duration of drug therapy.
One important factor is the relationship between renal clearance and the apparent volume of distribution. Renal clearance tends to be inversely proportional to the apparent volume of distribution. Drugs with an extensive distribution volume or those...
One important factor is the relationship between renal clearance and the apparent volume of distribution. Renal clearance tends to be inversely proportional to the apparent volume of distribution. Drugs with an extensive distribution volume or those...
01:17Factors Affecting Renal Clearance: Renal Impairment
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One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion
In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...