International Consensus Guidelines for the Optimal Use of the Polymyxins Endorsed by the American College of Clinical Pharmacy (ACCP), European Society of Clinical Microbiology and Infectious Diseases (ESCMID), Infectious Diseases Society of America (IDSA), International Society for Anti-infective Pharmacology (ISAP), Society of Critical Care Medicine (SCCM), and Society of Infectious Diseases Pharmacists (SIDP)
International Consensus Guidelines for the Optimal Use of the Polymyxins Endorsed by the American College of Clinical Pharmacy (ACCP), European Society of Clinical Microbiology and Infectious Diseases (ESCMID), Infectious Diseases Society of America (IDSA), International Society for Anti-infective Pharmacology (ISAP), Society of Critical Care Medicine (SCCM), and Society of Infectious Diseases Pharmacists (SIDP)
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DOI：
10.1002/phar.2209
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发表时间：
2019-01-01
期刊：
影响因子：
4.1
通讯作者：
Kaye, Keith S.
中科院分区：
文献类型：
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作者：
Tsuji, Brian T.;Pogue, Jason M.;Kaye, Keith S.
多粘菌素抗生素粘菌素（多粘菌素E）和多粘菌素B在20世纪50年代问世，因此没有经历当代药物开发程序。它们的临床应用最近已经恢复，作为对其他无法治疗的革兰氏阴性感染的补救性治疗发挥了重要作用。自从多粘菌素重新引入临床以来，由于存在几种不同的用于描述多粘菌素剂量的惯例，其配方的差异，过时的产品信息，以及药敏试验的不确定性导致如何最佳地使用粘菌素和多粘菌素b和多粘菌素b和多粘菌素b的剂量缺乏明明性。我们报告了美国临床药学学院（ACCP）、美国传染病学会（IDSA）、国际抗感染药理学学会（ISAP）、重症医学学会（SCCM）、和传染病药剂师学会（SIDP）。欧洲临床微生物学和传染病学会（ESCMID）赞同本文件作为共识声明。该文件中的总体结论得到了欧洲抗微生物药敏试验委员会（EUCAST）的认可。我们建立了一个多样化的国际专家小组，就药物的药代动力学和药效学特性、药代动力学靶点、多粘菌素药物的选择、给药、多粘菌素和多粘菌素B的剂量调整和监测、多粘菌素联合治疗的使用、鞘内治疗、吸入治疗、毒性和肾衰竭的预防等方面提出治疗建议。该治疗指南首次就粘菌素和多粘菌素B治疗提供了共识建议，旨在指导最佳临床使用。
The polymyxin antibiotics colistin (polymyxin E) and polymyxin B became available in the 1950s and thus did not undergo contemporary drug development procedures. Their clinical use has recently resurged, assuming an important role as salvage therapy for otherwise untreatable gram-negative infections. Since their reintroduction into the clinic, significant confusion remains due to the existence of several different conventions used to describe doses of the polymyxins, differences in their formulations, outdated product information, and uncertainties about susceptibility testing that has led to lack of clarity on how to optimally utilize and dose colistin and polymyxin B. We report consensus therapeutic guidelines for agent selection and dosing of the polymyxin antibiotics for optimal use in adult patients, as endorsed by the American College of Clinical Pharmacy (ACCP), Infectious Diseases Society of America (IDSA), International Society of Anti-Infective Pharmacology (ISAP), Society for Critical Care Medicine (SCCM), and Society of Infectious Diseases Pharmacists (SIDP). The European Society for Clinical Microbiology and Infectious Diseases (ESCMID) endorses this document as a consensus statement. The overall conclusions in the document are endorsed by the European Committee on Antimicrobial Susceptibility Testing (EUCAST). We established a diverse international expert panel to make therapeutic recommendations regarding the pharmacokinetic and pharmacodynamic properties of the drugs and pharmacokinetic targets, polymyxin agent selection, dosing, dosage adjustment and monitoring of colistin and polymyxin B, use of polymyxin-based combination therapy, intrathecal therapy, inhalation therapy, toxicity, and prevention of renal failure. The treatment guidelines provide the first ever consensus recommendations for colistin and polymyxin B therapy that are intended to guide optimal clinical use.