期刊
BRITISH JOURNAL OF CLINICAL PHARMACOLOGY
卷 73, 期 1, 页码 27-36出版社
WILEY
DOI: 10.1111/j.1365-2125.2011.04080.x
关键词
antibacterial; antibiotic; assay pharmacokinetics; pharmacodynamics; target concentration intervention; therapeutic drug management
资金
- Merck
- AstraZeneca
- Cubist
- Novartis
- Pfizer
- Hospira Australia P/l
- Burns Trauma and Critical Care Research Centre by National Health and Medical Research Council of Australia [519702]
- Royal Brisbane
- Women's Hospital Research Foundation
- National Health and Medical Research Council of Australia [569917]
Optimizing the prescription of antimicrobials is required to improve clinical outcome from infections and to reduce the development of antimicrobial resistance. One such method to improve antimicrobial dosing in individual patients is through application of therapeutic drug monitoring (TDM). The aim of this manuscript is to review the place of TDM in the dosing of antimicrobial agents, specifically the importance of pharmacokinetics (PK) and pharmacodynamics (PD) to define the antimicrobial exposures necessary for maximizing killing or inhibition of bacterial growth. In this context, there are robust data for some antimicrobials, including the ratio of a PK parameter (e.g. peak concentration) to the minimal inhibitory concentration of the bacteria associated with maximal antimicrobial effect. Blood sampling of an individual patient can then further define the relevant PK parameter value in that patient and, if necessary, antimicrobial dosing can be adjusted to enable achievement of the target PK/PD ratio. To date, the clinical outcome benefits of a systematic TDM programme for antimicrobials have only been demonstrated for aminoglycosides, although the decreasing susceptibility of bacteria to available antimicrobials and the increasing costs of pharmaceuticals, as well as emerging data on pharmacokinetic variability, suggest that benefits are likely.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据