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在强调“以药动学-药效学(PK-PD)关系作为抗生素疗法的评价依据”这一原则的基础上,对目前氟喹诺酮类抗菌药在重症监护病房(ICU)中的应用进行了综述。对于PK-PD的关系,要求氟喹诺酮在Cmax/MIC>12.1的同时,必须对革兰阴性菌和革兰阳性菌的AUC24h/MIC分别≥100~125h和≥30~40h,以确保临床疗效并尽可能避免耐药性的广泛发生。对于在ICU中的应用,总结了氟喹诺酮单独用药或与β-内酰胺类抗生素联合用药治疗在ICU中常见的菌血症/脓毒症、社区获得性肺炎、呼吸机相关肺炎、尿路感染和细菌性脑膜炎的效果,同时结合PK-PD关系的分析,说明了氟喹诺酮在对付ICU中这些常见的严重性感染的应用潜力。
Based on the principle of “pharmacokinetic-pharmacodynamic (PK-PD) relationship as the basis for evaluation of antibiotic therapy”, the current use of fluoroquinolone antibiotics in intensive care units (ICU) Summary. For the relationship between PK-PD, fluoroquinolones must be ≥100 ~ 125h and ≥30 ~ 40h AUC24h / MIC of Gram-negative bacteria and Gram-positive bacteria, respectively, in order to ensure the clinical efficacy and As much as possible to avoid the widespread occurrence of drug resistance. For use in the ICU, it is summarized that fluoroquinolone alone or in combination with a beta-lactam antibiotic treatment of bacteremia / sepsis, community-acquired pneumonia, ventilator-associated pneumonia, urinary tract infections And bacterial meningitis, combined with the analysis of PK-PD relationships, illustrates the potential of fluoroquinolones in addressing these common serious infections in the ICU.