(精选)The aminoglycoside antibiotics教学课件.pptVIP

The aminoglycoside antibiotics Introduction Semisynthetic Antibiotic Aminoglycosides exhibit concentration-dependent killing. The higher the peak, the more effective Aminoglycosides have a concentration-dependent postantibiotic effect. The postantibiotic effect is the phenomenon of continued bacterial killing even though serum concentrations have fallen below the minimum inhibitory concentration (MIC). Because the postantibiotic effect is concentration-dependent for the aminoglycosides, higher drug concentrations lead to a longer postantibiotic effect Spectrum of Activity Fairly broad spectrum of activity with some Gram + activity and very good Gram – activity Used for the treatment of: severe gram-negative infections such as pneumonia or bacteremia, often in combination with a β-lactam antibiotic. gram-positive infections such as infective endocarditis in combination with penicillins Two Dosing Approaches Conventional Dosing Extended-Interval Dosing When given as a 1/2-hour infusion (squares with solid line) , end of infusion concentrations are higher because the serum and tissues are not in equilibrium A 1/2-hour waiting time for aminoglycoside distribution to tissues is allowed before peak concentrations are measured If aminoglycosides are given as 1-hour infusions (circles with dashed line), distribution has an opportunity to occur during the infusion time, and peak concentrations can be obtained immediately In either case, concentrations 1 hour after the infusion was initiated are similar. Conventional Dosing Dose to achieve a target peak and trough concentration Dosing intervals generally range from every 8 (good renal function) to 24 hours (poor renal function) Conventional Dosing Aminoglycoside antibiotics are given as short-term (1/2–1 hour) infusions If a 1-hour infusion is used, maximum end of infusion “peak” concentrations are measured when the infusion is completed (Figure) If a 1/2-hour infusion is used, serum concentrations exhibit a dis