抗菌药物的种类和合应用wz.pptVIP

理想的抗菌药物 覆盖常见的病原体 包括耐药菌株 有好的组织穿透性 无药物间相互作用 无副反应 单药治疗 低耐药率和可接受的费用 * Pharmacokinetic/Pharmacodynamic Parameters Influencing Efficacy Bacterial killing is a function of drug concentration at the site of infection and the time of exposure. The product of these pharmacokinetic measures is the area under the serum-concentration time curve (AUC). Over clinically obtainable drug concentrations, simplifying assumptions can be made so that either drug concentration or time of drug exposure is of primary importance. When these assumptions cannot be made, both concentration and time of drug exposure (AUC) must be considered. For b-lactam and macrolide antibiotics, the duration of exposure is most crucial for bacterial killing. For these drugs, the time the drug concentration remains above the MIC of the infecting pathogen is the appropriate pharmacodynamic parameter. For aminoglycosides, peak to MIC ratios are most predictive of bacterial killing.1-2 For quinolones, both concentration and time of exposure must be considered to predict clinical efficacy (eg, AUC:MIC ratio.) References 1. Craig WA: Pharmacokinetic/pharmacodynamic parameters: Rationale for antibacterial dosing of mice and men. Clin Infect Dis 26:1-12, 1998. 2. Ambrose PG, Owens RC, Grasela D: Antimicrobial Pharmacodynamics: The scientific basis of therapeutics. Med Clin North America. In-press. Slide 10 * MPC是最新的研究药物有效性及耐药性的重要参数。 * 1. IMS MIDAS, YTD Q2 2000. Prescription volume sales indicate that ?-lactam antibiotics are the most frequently prescribed antibiotics.1 These agents account for over 50% of prescriptions and represent the cornerstone of society’s fight against bacterial infection. 头孢哌酮 and 头孢哌酮/舒巴坦 belongs to one of the most frequently prescribed subclass of ?-lactam compounds, the cephalosporins, which account for nearly 25% of all antibiotic prescriptions. * 医生必须经常为危重病患者选择经验性抗菌药物治疗方案。 早期适当的抗菌药物治疗包括经验性选择针对可能导致感染的致病菌的治疗。 应当根据最新的微生物学和药敏资料，以及医生对患者疾病恶化和死亡危险的评估，进行经验性选择以开始早期适当的抗菌药物治疗。 所选择的抗菌药物应该具有很好