成人危重患者利奈唑胺个体化用药的研究进展

Progress in individualized use of linezolid in adult critically ill patients

利奈唑胺是临床常用的一种抗感染药物。考虑到危重患者个体病情差异大、基础疾病重、脏器功能差、用药品种及数量多等因素,标准剂量的利奈唑胺可能并不适用。本文综述了近年来成人危重患者使用利奈唑胺的相关研究,分析了该类人群的药动学特征,归纳了危重患者常见生理/病理改变对药物的影响。在使用利奈唑胺时,临床应加强对这一特殊群体的综合评估,除适当减少肝/肾功能损伤患者的用药剂量外,还需在其他情况下多考虑适当增加用药剂量。用药后,为避免药物暴露过量或不足,临床应加强用药监护,尤其应利用好治疗药物监测这一重要手段。

Linezolid is an anti-infective drug commonly used in clinic. Considering the large difference of individual condition,severe basic disease,poor organ function and large variety and quantity of drugs,standard dose of linezolid may not be suitable for all critically ill patients. This paper reviews the relevant researches on the application of linezolid in adult critically ill patients in recent years,analyzes the pharmacokinetic characteristics of critically ill patients,and summarizes the influence of common physiological and pathological changes in critically ill patients on drugs. When using linezolid, the clinical comprehensive evaluation of this special group should be strengthened. In addition to appropriately reducing the drug dosage of patients with liver/kidney function injury,it is also necessary to consider appropriately increasing the drug dosage in other cases. After medication,in order to avoid excessive or insufficient drug exposure,clinical medication monitoring should be strengthened,especially the important mean as therapeutic drug monitoring should be used well.