医学
指南
加药
重症监护医学
药店
抗生素
临床药学
治疗药物监测
抗菌化疗
药理学
药代动力学
家庭医学
病理
微生物学
生物
作者
Lisa Hong,Kevin J. Downes,Alireza FakhriRavari,Jacinda C. Abdul‐Mutakabbir,Joseph L. Kuti,Sarah C J Jorgensen,David C. Young,Mohammad H. Al‐Shaer,Matteo Bassetti,Robert A. Bonomo,Mark Gilchrist,Soo Min Jang,Thomas P. Lodise,Jason A. Roberts,Thomas Tängdén,Athena F. Zuppa,Marc H. Scheetz
摘要
Abstract Intravenous β‐lactam antibiotics remain a cornerstone in the management of bacterial infections due to their broad spectrum of activity and excellent tolerability. β‐lactams are well established to display time‐dependent bactericidal activity, where reductions in bacterial burden are directly associated with the time that free drug concentrations remain above the minimum inhibitory concentration (MIC) of the pathogen during the dosing interval. In an effort to take advantage of these bactericidal characteristics, prolonged (extended and continuous) infusions (PIs) can be applied during the administration of intravenous β‐lactams to increase time above the MIC. PI dosing regimens have been implemented worldwide, but implementation is inconsistent. We report consensus therapeutic recommendations for the use of PI β‐lactams developed by an expert international panel with representation from clinical pharmacy and medicine. This consensus guideline provides recommendations regarding pharmacokinetic and pharmacodynamic targets, therapeutic drug‐monitoring considerations, and the use of PI β‐lactam therapy in the following patient populations: severely ill and nonseverely ill adult patients, pediatric patients, and obese patients. These recommendations provide the first consensus guidance for the use of β‐lactam therapy administered as PIs and have been reviewed and endorsed by the American College of Clinical Pharmacy (ACCP), the British Society for Antimicrobial Chemotherapy (BSAC), the Cystic Fibrosis Foundation (CFF), the European Society of Clinical Microbiology and Infectious Diseases (ESCMID), the Infectious Diseases Society of America (IDSA), the Society of Critical Care Medicine (SCCM), and the Society of Infectious Diseases Pharmacists (SIDP).
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