多黏菌素注射液在儿童感染中的应用

Application of Polymyxin Injection in Children’s Infection

目的了解近年来多黏菌素注射液在儿童感染中的应用现状,为儿童合理地使用多黏菌素类药物提供参考。方法以"黏菌素"、"多黏菌素B"、"polymyxin"、"colistin"、"儿童"和"children"等为关键词,组合查询2000年—2020年5月在中国知网、万方、PubMed、Embase和Cochance libray等数据库中的相关文献,对重症感染儿童使用多黏菌素注射液的药代动力学特点及其有效性和安全性现状进行归纳总结。结果儿童使用多黏菌素注射液具有较高的临床疗效,且其主要不良反应肾毒性的发生率并不高于成人,但新生儿使用多黏菌素注射液需要加强对电解质的监测。结论药代动力学研究数据显示目前儿童使用多黏菌素注射液可能普遍存在剂量不足现象,使用大剂量多黏菌素注射液的药代动力学特征、有效性和安全性还需要开展大规模临床研究进一步进行评估。

Objective To understand the current status of polymyxin research in children in recent years and promote the rational use of polymyxin in children Methods We systematicly searched CNKI,CBM,Wanfang,PubMed,EMBASE,Web of Science and Cochance library databases from 2000 to May 2020 using"polymyxin","colistin"and"children"as keywords.The pharmacokinetic characteristics of polymyxin and the current status of clinical efficacy and safety of polymyxin in children were summarized.Results Polymyxin has a high clinical efficacy in children,and the incidence of nephrotoxicity is not higher than that of adults.But requires increased monitoring of electrolytes when its use in neonates.Conclusions The available pharmacokinetic data suggest that there may be a general inadequate dose of polymyxin in children at present,and further clinical studies are needed to evaluate the pharmacokinetic profile,efficacy and safety of polymyxin in large doses.