碳青霉烯类在抗感染治疗中给药方案优化研究进展

Research Progress on Optimization of Carbapenem Dosage Regimen in Critically Ill Patients

耐药病原菌的出现、药动学的改变以及药动学/药效学靶值的争议使碳青霉烯类在重症患者中的合理应用面临挑战,因此对碳青霉烯类的给药方案进行优化迫在眉睫。通过查阅国内外相关文献,对碳青霉烯类在重症患者中的临床应用及给药方案优化研究进展进行综述。结果发现根据重症患者的生理病理特征结合碳青霉烯类的药动学/药效学特征,可通过调整药物剂量、改变给药间隔、调整输注时间、治疗药物监测、联合用药及利用个体化给药软件等方式优化碳青霉烯类给药方案,从而提高临床疗效并减少不良反应的发生。

The rational use of carbapenem is challenged in critically ill patients by the emergence of drug-resistant pathogens,the alterations of drug pharmacokinetics and the controversy over the pharmacokinetic/pharmacodynamic targets.Therefore,the optimization of carbapenem dosage regimen is imperative.This paper reviewed the research progress on the clinical application and dosage regimen of carbapenem in critically ill patients by reviewing the relevant domestic and international literatures.In order to improve clinical efficacy and reduce adverse reactions,the administration of carbapenem can be optimized by adjusting dosage,changing the administration interval,adjusting infusion time,performing therapeutic drug monitoring,combining with other drugs and using individual admin-istration software,which is based on the physiological and pathological of critically ill patients and the pharmacokinetic/pharmacodynamic of carbapenem.