抗生素治疗的一般原则

DeckerMed Medicine Pub Date : 2021-01-09 DOI:10.2310/FM.1475
A. Letourneau, M. Calderwood
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引用次数: 0

摘要

有效抗生素的基本特征是能够在宿主耐受的浓度下抑制微生物的生长。抗生素通常针对细菌特有的解剖结构或生物合成途径。抗生素的适当选择取决于以下因素:临床医生的怀疑程度;感染菌及其对抗生素的敏感性;感染类型;与特定抗生素相关的因素;宿主因素;还有公共卫生方面的考虑。本文综述了抗生素治疗的概况,包括确定感染的原因、确定细菌对特定药物的敏感性、感染部位和辅助治疗、抗生素药物靶点、药效学参数、影响剂量和给药途径的因素、宿主因素、抗生素治疗的并发症、艰难梭菌感染和抗菌素耐药性。本综述包含2张图,7张表,45篇参考文献。关键词:抗菌治疗,抗生素,感染,微生物,肾给药,肝给药,艰难梭菌
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General Principles of Antibiotic Therapy
The essential feature of effective antibiotic agents is the ability to inhibit the growth of microorganisms at concentrations tolerated by the host. Antibiotic agents generally target anatomic structures or biosynthetic pathways unique to bacteria. The appropriate choice of an antibiotic for an infection depends on the following: clinician’s level of suspicion; the infecting organism and its antibiotic susceptibilities; the type of infection; factors associated with specific antibiotic agents; host factors; and public health considerations. This review provides an overview of antibiotic therapy and covers identifying the cause of an infection, determination of bacterial susceptibility to specific drugs, site of infection and ancillary therapy, antibiotic drug targets, pharmacodynamic parameters, factors affecting dosage and route of administration, host factors, complications of antibiotic therapy, Clostridium difficile infection, and antimicrobial resistance.  This review contains 2 figures, 7 tables, and 45 references. Key words: Antimicrobial therapy, antibiotic, infection, microorganism, renal dosing, hepatic dosing, Clostridium difficile  
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