2012根据PKPD理论合理使用抗菌药南京.pptVIP

体温小于等于37.9度，白细胞恢复到5000-10000，有以上两点同时临床症状好转（脓痰减少）认为治愈，细菌根除不作为治愈标准（因为不重复查） We caution against extrapolating these data to single daily dosing regimens with aminoglycosides since the majority of our patients were dosed two to three times daily, and thus, optimal Cmax/MIC ratios were obtained multiple times within a 24-h interval (iii) Toxicity evaluation. Aminoglycoside-associated nephrotoxicity was de- ?ned as a rise in the serum creatinine concentration of $0.5 mg/dl if the initia serum creatinine concentration was ,3.0 mg/dl or a rise of 1.0 mg/dl if the initia serum creatinine concentration was 3.0 mg/dl (3). S.Pneumoniae 肺炎链球菌 Negative 阴性 * mutant prevention concentration（MPC）：防突变浓度。 * Static 静止 抑制 Cidal 杀灭 Optimal 理想的 Carbapenems 碳青霉烯类 Cephalosporins 头孢类 * 配置好的特治星室温24h稳定，2-8度48h稳定 Azithromycin 阿奇霉素 Clarithromycin 克拉霉素 Telithromycin 泰利霉素 ABT-773(Cethromycin,喹红霉素):酮内酯类 1 * S.?aureus 金黄色葡萄球菌 S.?epidermidis 表皮 * 108位病人, RESULTS: The median age of the 108 patients studied was 74 (range 32-93) years. Measured vancomycin AUC24/MIC values were precisely predicted with the A.U.I.C. calculator in a subset of our patients (r2 = 0.935). Clinical and bacteriological response to vancomycin therapy was superior in patients with higher ( or = 400) AUC24/MIC values (p = 0.0046), but no relationship was identified between vancomycin %TimeMIC and infection response. Bacterial eradication of S. aureus (both methicillin-susceptible and methicillin-resistant) occurred more rapidly (p = 0.0402) with vancomycin when a threshold AUC24/MIC value was reached. S. aureus killing rates were slower with vancomycin than with other antistaphylococcal antibacterials (p = 0.002). There was a significant relationship (p 0.0001) between time to bacterial eradication and the time to substantial improvement in pneumonia score. CONCLUSIONS: Vancomycin AUC24/MIC values predict time-related clinical and bacteriological outcomes for patients with lower respiratory tract infections caused b