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肽类抗生素的药代动力学和药效学。

Pharmacokinetics and pharmacodynamics of peptide antibiotics.

机构信息

Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, China; Key Laboratory of Clinical Pharmacology of Antibiotics, Shanghai, China; National Health Commission & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China; School of Pharmacy, Fudan University, Shanghai, China.

Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, China; Key Laboratory of Clinical Pharmacology of Antibiotics, Shanghai, China; National Health Commission & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China; School of Pharmacy, Fudan University, Shanghai, China; Phase I Unit, Huashan Hospital, Fudan University, Shanghai 200040, China.

出版信息

Adv Drug Deliv Rev. 2022 Apr;183:114171. doi: 10.1016/j.addr.2022.114171. Epub 2022 Feb 18.

Abstract

Antimicrobial resistance is a major global health challenge. As few new efficacious antibiotics will become available in the near future, peptide antibiotics continue to be major therapeutic options for treating infections caused by multidrug-resistant pathogens. Rational use of antibiotics requires optimisation of the pharmacokinetics and pharmacodynamics for the treatment of different types of infections. Toxicodynamics must also be considered to improve the safety of antibiotic use and, where appropriate, to guide therapeutic drug monitoring. This review focuses on the pharmacokinetics/pharmacodynamics/toxicodynamics of peptide antibiotics against multidrug-resistant Gram-negative and Gram-positive pathogens. Optimising antibiotic exposure at the infection site is essential for improving their efficacy and minimising emergence of resistance.

摘要

抗菌药物耐药性是一个全球性的主要健康挑战。由于在不久的将来几乎不会有新的有效抗生素问世,因此肽类抗生素仍然是治疗多药耐药病原体引起的感染的主要治疗选择。合理使用抗生素需要优化治疗不同类型感染的药代动力学和药效学。还必须考虑毒代动力学,以提高抗生素使用的安全性,并在适当情况下指导治疗药物监测。本综述重点介绍了针对多药耐药革兰氏阴性和革兰氏阳性病原体的肽类抗生素的药代动力学/药效学/毒代动力学。优化感染部位的抗生素暴露对于提高疗效和最小化耐药性的产生至关重要。

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