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抗感染治疗的目标不仅是治愈患者,而且要通过合理使用抗生素达到优化抗感染治疗的目的,即提高药物的疗效、减少抗生素毒副反应的同时,有效防止耐药产生,而药代动力学和药效学动力学(PK/PD)是实现优化抗菌治疗的重要依据。本文回顾了PK/PD理论中几个重要的参数:AUC、Cmax、T>MIC、PAE、AUC24/MIC、Cmax/MIC、AUC>MIC。根据这些参数可以将治疗呼吸道感染常用的几类抗生素分为3大类:时间依赖性抗生素、浓度依赖性抗生素、以及介于浓度、时间依赖之间的抗生素,并从机制上探究它们各自最佳的给药方案。最后根据防细菌耐药突变浓度(MPC)理论提出了感染治疗中防止耐药产生的几种措施。
The goal of anti-infective therapy is not only to cure patients, but also through the rational use of antibiotics to achieve the purpose of optimizing anti-infective treatment, that is, to improve the efficacy of drugs to reduce side effects of antibiotics, while effectively preventing drug resistance, and pharmacokinetics and Pharmacodynamics (PK / PD) is an important basis to achieve optimal antibacterial therapy. This article reviews several important parameters in PK / PD theory: AUC, Cmax, T> MIC, PAE, AUC24 / MIC, Cmax / MIC, AUC> MIC. According to these parameters, several types of antibiotics commonly used in the treatment of respiratory infections can be divided into three categories: time-dependent antibiotics, concentration-dependent antibiotics, and concentration- and time-dependent antibiotics, and to explore their respective best mechanisms Dosing regimen. Finally, according to the anti-bacterial drug resistance mutation concentration (MPC) theory put forward several measures to prevent drug resistance in the treatment of infection.