Pharmacokinetic changes and dosing modification of aminoglycosides in critically ill obese patients: a literature review.
Pharmacokinetic changes and dosing modification of aminoglycosides in critically ill obese patients: a literature review.
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DOI：
10.14740/jocmr1858w
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发表时间：
2014-08
期刊：
影响因子：
--
通讯作者：
Karanikolas M
中科院分区：
文献类型：
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作者：
Velissaris D;Karamouzos V;Marangos M;Pierrakos C;Karanikolas M
本文的目的是回顾文献，并对危重肥胖症患者使用氨基糖苷类抗生素提供建议。在PubMed中检索所有关于氨基糖苷类药物在重症肥胖患者中使用的文章，并对所有与肥胖的药代动力学相关的文章进行综述。还审查了所有搜索到的手稿的参考书目，以期找到更多的参考文献。虽然氨基糖苷类药物的药代动力学已被详细描述，但有关危重肥胖症患者氨基糖苷类药物使用和适当剂量调整的数据非常有限。关于氨基糖苷类药物在重症肥胖患者中的药代动力学和使用方面的知识是不完整的。肥胖症的病理生理变化可导致氨基糖苷类药物的血浆浓度低于或超过治疗水平，尤其是在出现败血症的情况下。需要严格的临床研究来建立重症肥胖症脓毒症患者氨基糖苷类药物的剂量指南。
The objective of the paper is to review the literature and provide recommendations for use of aminoglycoside antibiotics in critically ill obese patients. Literature search in PubMed for all articles on the use of aminoglycosides in critically ill obese patients was conducted, and all articles related to pharmacokinetics in obesity were reviewed. Bibliographies of all searched manuscripts were also reviewed in an attempt to find additional references. Although aminoglycoside pharmacokinetics have been described in detail, data on aminoglycoside use and appropriate dose modification in critically ill obese patients are very limited. Knowledge on aminoglycoside pharmacokinetics and use in critically ill obese patients is incomplete. Pathophysiologic changes in obesity can result in sub- or supra-therapeutic aminoglycoside plasma concentrations, especially in the presence of sepsis. Rigorous clinical studies are needed to establish aminoglycoside dosing guidelines in critically ill obese patients with sepsis.