- 1、本文档共64页,可阅读全部内容。
- 2、原创力文档(book118)网站文档一经付费(服务费),不意味着购买了该文档的版权,仅供个人/单位学习、研究之用,不得用于商业用途,未经授权,严禁复制、发行、汇编、翻译或者网络传播等,侵权必究。
- 3、本站所有内容均由合作方或网友上传,本站不对文档的完整性、权威性及其观点立场正确性做任何保证或承诺!文档内容仅供研究参考,付费前请自行鉴别。如您付费,意味着您自己接受本站规则且自行承担风险,本站不退款、不进行额外附加服务;查看《如何避免下载的几个坑》。如果您已付费下载过本站文档,您可以点击 这里二次下载。
- 4、如文档侵犯商业秘密、侵犯著作权、侵犯人身权等,请点击“版权申诉”(推荐),也可以打举报电话:400-050-0827(电话支持时间:9:00-18:30)。
查看更多
结束语 抗菌药物的临床合理应用 还需要我们大家共同努力 ——谢谢各位—— * 抗生素按杀菌活性可分成二类: 时间依赖型 浓度依赖型 * 时间依赖型的抗生素主要的一大类就是b -内酰胺类 (青霉素类、头孢菌素、氨曲南、碳烯类),克林和大环(红、克、阿奇)、四环、链、万古,是目前临床上应用最多的一些抗生素 它有以下特点: 持续后效应-无或轻、中度 在MIC4-5倍时杀菌率即处于饱和 杀菌范围主要依赖于接触时间 血药浓度超过MIC时间是与临床疗效相关的主要参数 * 浓度依赖型的抗生素包括氨基糖苷类和喹诺酮类,甲硝唑 它有以下几个特点 投药目标达到最大药物接触,药物浓度越高,杀菌率及杀菌范围也越大 24小时AUC(浓度时间曲线下面积)/MIC、峰浓度/MIC是疗效相关的主要参数 * This slide represents key factors involved in antimicrobial therapy. Once the dose is administered, pharmacokinetic parameters then describe what happens to the drug once it enters the body. Absorption from the GI tract is essential for oral therapy. Once in the blood stream critical factors for success include distribution of the drug into the infected tissues. How long a drug remains in the blood stream is determined by half-life (metabolism or excretion) The distribution and metabolism of the drug can have an impact on safety (hepatic metabolites) or efficacy (urine excretion unchanged for UTI). The degree of protein binding can impact the microbiologic activity Pharmacodynamics represents the relationship between the pharmacologic activity (MIC) and pharmacokinetics (AUC or peak concentrations). The pharmacologic activity of an antibiotic can be defined by whether they are time-dependent, (effect can be predicted by time above the MIC, or concentration dependent - higher the concentration the greater the bacterial killing) as defined by peak:MIC or AUC:MIC ratios. In addition, post antibiotic effect (PAE) or the continued bacterial killing when the antibiotic blood level fall below the MIC can also impact efficacy. Pharmacologic effect can be determined by a decline in bacterial colony counts which is typically observed in in vitro models. Mortality rates in animal studies is another endpoint and finally in human trials, resolution of signs and symptoms of an infection typically determines clinical success rates. * 不同的抗生素的抗菌效力参照的药动学/药效学参数不一样。 青、头孢、碳青烯、氨曲、大环,克林,参照 (TMIC) 氨基糖苷、氟喹酮、阿奇,参照24hr AUC/MIC 四环、万古、链阳、氨基糖苷、氟喹酮
文档评论(0)