重症患者的抗生素剂量优化:目标、证据和未来战略。

IF 3.5 3区 医学 Q1 CRITICAL CARE MEDICINE Current Opinion in Critical Care Pub Date : 2024-10-01 Epub Date: 2024-07-05 DOI:10.1097/MCC.0000000000001187
Christopher J Dyer, Jan J De Waele, Jason A Roberts
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引用次数: 0

摘要

综述目的:强调抗生素药代动力学和药效学(PK/PD)在改善败血症和脓毒性休克患者预后方面的最新证据。我们还总结了现有数据的局限性,并描述了未来的研究方向,以支持将抗生素剂量优化应用于临床:脓毒症和脓毒性休克与不良预后有关,需要优化抗生素剂量,这主要是由于药代动力学发生了显著改变。许多研究,包括一些随机对照试验,都是为了衡量抗生素剂量优化干预措施(包括使用治疗药物监测)的临床效果。目前的数据支持对重症患者进行抗生素剂量优化。摘要:抗生素剂量优化似乎可以改善脓毒症和脓毒性休克重症患者的预后,但还需要进一步的研究来量化获益程度,并进一步了解新技术在促进剂量优化方面的作用。
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Antibiotic dose optimisation in the critically ill: targets, evidence and future strategies.

Purpose of review: To highlight the recent evidence for antibiotic pharmacokinetics and pharmacodynamics (PK/PD) in enhancing patient outcomes in sepsis and septic shock. We also summarise the limitations of available data and describe future directions for research to support translation of antibiotic dose optimisation to the clinical setting.

Recent findings: Sepsis and septic shock are associated with poor outcomes and require antibiotic dose optimisation, mostly due to significantly altered pharmacokinetics. Many studies, including some randomised controlled trials have been conducted to measure the clinical outcome effects of antibiotic dose optimisation interventions including use of therapeutic drug monitoring. Current data support antibiotic dose optimisation for the critically ill. Further investigation is required to evolve more timely and robust precision antibiotic dose optimisation approaches, and to clearly quantify whether any clinical and health-economic benefits support expanded use of this treatment intervention.

Summary: Antibiotic dose optimisation appears to improve outcomes in critically ill patients with sepsis and septic shock, however further research is required to quantify the level of benefit and develop a stronger knowledge of the role of new technologies to facilitate optimised dosing.

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来源期刊
Current Opinion in Critical Care
Current Opinion in Critical Care 医学-危重病医学
CiteScore
5.90
自引率
3.00%
发文量
172
审稿时长
6-12 weeks
期刊介绍: ​​​​​​​​​Current Opinion in Critical Care delivers a broad-based perspective on the most recent and most exciting developments in critical care from across the world. Published bimonthly and featuring thirteen key topics – including the respiratory system, neuroscience, trauma and infectious diseases – the journal’s renowned team of guest editors ensure a balanced, expert assessment of the recently published literature in each respective field with insightful editorials and on-the-mark invited reviews.
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