Dosing of colistin-back to basic PK/PD.

Dosing of colistin-back to basic PK/PD.
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DOI:
10.1016/j.coph.2011.07.004
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发表时间:
2011-10
影响因子:
4
通讯作者:
Nation, Roger L.
Nation, Roger L.
中科院分区:
医学3区
文献类型:
--
作者:
Bergen, Phillip J.;Li, Jian;Nation, Roger L.

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全球范围内多重耐药革兰氏阴性菌的流行率不断上升,导致对以前被丢弃的抗生素粘菌素进行重新评估。尽管其作为不可治疗的感染的挽救治疗的重要作用,但前药甲磺酸粘杆菌素(CMS)的剂量指南没有科学依据,并导致治疗失败和增加粘杆菌素耐药性。在这篇综述中,我们总结了最近取得的进展,在了解CMS和形成粘菌素的药代动力学,重点是危重病人。粘菌素的药效学也进行了审查,特别注意药代动力学和药效学之间的关系,以及如何新兴的数据可以用来通知最佳剂量方案的设计。最近的数据表明,CMS的当前剂量方案在许多危重患者中是次优的。
The increasing prevalence of multidrug-resistant Gram-negative bacteria worldwide has led to a re-evaluation of the previously discarded antibiotic, colistin. Despite its important role as salvage therapy for otherwise untreatable infections, dosage guidelines for the prodrug colistin methanesulfonate (CMS) are not scientifically based and have led to treatment failure and increased colistin resistance. In this review we summarise the recent progress made in the understanding of the pharmacokinetics of CMS and formed colistin with an emphasis on critically-ill patients. The pharmacodynamics of colistin is also reviewed, with special attention given to the relationship between pharmacokinetics and pharmacodynamics and how the emerging data can be used to inform design of optimal dosage regimens. Recent data suggest the current dosage regimens of CMS are sub-optimal in many critically-ill patients.
DOI: 10.1111/j.1476-5381.1967.tb01946.x
发表时间: 1967-01-01
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