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1.
丁玉峰  查仲玲 《医药导报》2004,23(2):0095-0096
抗菌药物双向个体化是以感染患者个体的病原菌对抗菌药物的药效学反应浓度(DRC)或最低抑菌浓度(MIC)作药效学基础,同时以患者个体体内药物浓度来推算药动学参数,实现抗菌药物和病原菌之间的体外药效学与抗菌药物和患者的体内药动学的结合,是抗菌药物个体化用药方案设计的理想方法之一。概述抗菌药物双向个体化的概念、特点及在老年严重感染性疾病治疗中的作用,介绍用双向个体化法设计老龄感染患者用药方案及应注意的问题。  相似文献   

2.
目的:分析感染病医院感染性疾病抗菌药物用药评价与耐药性,为感染病医院合理用药提供参考。方法:实行临床药师参与查房、会诊制度,根据药敏结果与"安全、有效、经济"的用药原则,当好临床医师用药参谋。结果:青霉素类与头孢菌素类(包括β-内酰胺酶抑制剂的复合制剂)及时进行对细菌的耐药性分析,调整感染病治疗的用药方案,及时纠正抗菌药物的不合理使用。结论:感染病医院感染性疾病的抗菌药物使用,应根据感染性疾病的临床症状进行病原学药敏检测,合理选择抗菌药物。  相似文献   

3.
《抗感染药学》2017,(4):798-800
目的:分析老年呼吸内科感染患者的感染因素及其治疗对策,为临床诊治提供参考。方法:选取2015年5月—2016年8月期间收治的老年呼吸内科感染患者50例,采用回顾性分析法分析其呼吸内科感染的部位、相关因素以及合理使用抗菌药物治疗对策。结果:50例老年呼吸内科感染患者的感染部位以呼吸道为主,侵入性诊治、患者年龄、近期使用抗菌药物的情况以及住院时间、合并慢性基础性疾病及并发症等因素均与感染有关,经组间比较其差异有统计学意义(P<0.05);合理使用抗菌药物治疗后发生1例患者病死,其余患者的病情均得到明显缓解。结论:临床引发呼吸内科老年患者感染的因素各异,需加以重视;应针对其感染的具体情况,结合药敏试验检查结果,合理使用抗菌药物治疗,以提高其生活质量。  相似文献   

4.
目的 探讨临床药师在抗感染药物治疗中发挥的作用。方法 临床药师通过参与1例浅黄假单胞菌血流感染合并终末期肾病患者的药学实践,探讨如何为感染合并肾病患者制定合理的抗感染治疗方案。结果 临床药师积极参与药物治疗,依据指南评价抗感染治疗方案,根据药敏结果和患者既往史,给予合理的抗感染治疗方案的修改建议,最终感染得到有效控制。结论 感染严重影响生活质量。临床药师协助医师选择适宜的抗菌药物、用法用量、正确联合用药,关注药物不良反应,制定个体化给药方案,保障感染合并肾病患者有效并合理应用抗菌药物。  相似文献   

5.
《抗感染药学》2016,(5):1060-1063
目的:分析鲍曼不动杆菌感染患者临床治疗的药学监护及抗菌药物合理使用。方法:临床药师对1例泛耐药鲍曼不动杆菌肺部感染患者的治疗过程进行全程监护,分析抗菌药物的合理使用。结果:该患者鲍曼不动杆菌定植与感染交替存在,对于鲍曼不动杆菌感染时,按《抗菌药物临床应用指导原则》要求联合用药治疗;要提高免疫力,加强防治。结论:鲍曼不动杆菌的定植和感染的区分仍是临床上的难点,需结合患者临床症状和检验指标判断,临床药师可参与患者个体化用药方案的制订以保证患者的用药安全、有效。  相似文献   

6.
李莉霞  卜书红  李方  杨怡  张健 《中国药房》2014,(14):1334-1336
目的:总结本院药师在术后感染会诊方面的实践经验和体会,供临床药学工作者参考。方法:结合本院临床药师参与会诊的典型术后感染病例,分析术后感染的及时诊断、个体化的抗菌药物应用和疾病的转归,总结术后感染药师会诊的经验。结果:判断术后发热是否是感染性发热,是药学会诊的关键点和难点;早期准确的判断感染部位,是药学会诊经验性用药的重要依据;及时评价术后感染程度、调整治疗方案,是降低死亡率的重要措施;临床药师应结合患者的具体情况,制订个体化抗感染治疗方案;掌握药品的特点,监测患者相关指标的动态变化,关注患者的用药安全,制订个体化药学监护计划。结论:复杂的术后感染要及时地控制,不仅需要对致病菌正确的判断和合理的应用抗菌药物,还需要对患者术中及术后病情变化正确的分析、判断和评估,在个体化的药学监护下应用安全、有效、合理的抗菌方案。  相似文献   

7.
合理、准确地使用抗菌药物是感染性心内膜炎治疗的关键。本文报道了1例感染性心内膜炎患者的抗感染治疗过程。患者外院治疗效果不佳、未明确感染病原体,在我院治疗过程中肌酸酐清除率处于较高水平。患者治疗期间,临床药师加入诊疗团队、参与制定个体化抗感染治疗方案。根据患者病原学结果、肾功能情况及抗菌药物药代动力学特点等加以分析,患者经过多次用药调整后,病情较前明显好转,感染指标及体温降至正常范围,无药物不良反应发生。患者一般情况好,感染得到了有效控制,转当地医院继续治疗。本文通过1例感染性心内膜炎患者的用药点评,旨在探讨此类患者抗感染药物的合理应用及临床药师开展药学服务工作的切入点。  相似文献   

8.
合理、准确地使用抗菌药物是感染性心内膜炎治疗的关键。本文报道了1例感染性心内膜炎患者的抗感染治疗过程。患者外院治疗效果不佳、未明确感染病原体,在我院治疗过程中肌酸酐清除率处于较高水平。患者治疗期间,临床药师加入诊疗团队、参与制定个体化抗感染治疗方案。根据患者病原学结果、肾功能情况及抗菌药物药代动力学特点等加以分析,患者经过多次用药调整后,病情较前明显好转,感染指标及体温降至正常范围,无药物不良反应发生。患者一般情况好,感染得到了有效控制,转当地医院继续治疗。本文通过1例感染性心内膜炎患者的用药点评,旨在探讨此类患者抗感染药物的合理应用及临床药师开展药学服务工作的切入点。  相似文献   

9.
目的:探讨临床药师在糖尿病合并气性坏疽患者个体化治疗中的作用。方法:临床药师通过参与糖尿病合并气性坏疽患者个体化治疗的救治工作,发挥自身药学特长,结合指南、药物敏感性试验结果、药物特点、用药经验等方面知识,帮助临床医师调整给药方案,合理选择抗菌药物和用药剂量。结果:通过个体化用药方案成功抢救糖尿病合并气性坏疽患者。结论:临床药师参与临床治疗,可以弥补医师对抗菌药物知识的不足,有利于提高临床治疗水平,促进合理用药。  相似文献   

10.
目前,由于抗菌药物的不合理应用,导致大量耐药菌的产生,给临床治疗带来很大困难,重视医院抗菌药物的合理使用已刻不容缓.为此,笔者就抗菌药物的临床合理应用方法探讨如下. 1 严格掌握用药指征 抗菌药物主要用于治疗细菌、衣原体、支原体、立克次体、真菌、放线菌和螺旋体所致的感染性疾病,非上述感染原则上不用抗菌药物,因此,在使用抗菌药物前,明确诊断是合理使用抗菌药物最关键的一步.要求临床医师要紧密结合患者的症状体征、血、尿常规、病原学检查等实验室检查结果及流行病学资料,提高确诊细菌及其他病微生物所致感染的能力,并排除病毒性感染的可能[1].  相似文献   

11.
感染性疾病的治疗并非是抗菌药物与细菌一对一的作用,机体的免疫功能对疾病恢复起着重要的作用,临床医生有必要熟悉抗菌药物对机体免疫功能的影响。研究表明,多种抗菌药物对机体免疫功能有一定的调节作用。  相似文献   

12.
The advent of the antibiotic era ushered in a shift towards non-pathogen-specific therapy of infectious diseases. This led to an overt emphasis on targeting microbial pathogens while strategies directed towards enhancing host immunity were neglected. In an effort to decrease sole reliance on antimicrobials, the time has come for a critical reappraisal of nonantibiotic, albeit immune response-enhancing substances. The diverse array of natural, synthetic, and recombinant immunomodulators discussed in this review succinctly demonstrate the potential of these agents to stimulate host defense mechanisms for prophylaxis and treatment of various microbial infections.  相似文献   

13.
Alvarez-Lerma F  Palomar M  Grau S 《Drugs》2001,61(6):763-775
Indications for the use of antimicrobials in critically ill patients are similar to those for other hospitalised patients. However, the selection of agents depends on the particular characteristics of patients in the intensive care unit (ICU), the form of presentation of infection, the type of infection and the bacteriological features of the causative pathogens. The use of antimicrobials in patients admitted to medical-surgical ICUs varies between 33 and 53%. The selection of empirical antimicrobials to be included in treatment protocols of the most common infections depends on the strong interrelationship between patient characteristics, predominant pathogens in each focus. and antimicrobials used for treatment. Epidemiological studies carried out in the past have identified the microorganisms most frequently responsible for community-acquired and nosocomial infections in patients admitted to ICUs. Susceptibility to antimicrobial agents may be different between each geographical area, between each hospital and even within the same hospital service. In addition, susceptibility patterns may change temporarily in relation to the use of particular antimicrobials or in association with other unknown factors so that assessment of endemic antimicrobial resistance patterns is very useful in order to tailor the antimicrobial regimens of therapeutic protocols. Antimicrobial use should not be a routine procedure. The clinical course of the patient (an indicator of effectiveness) should be closely monitored as well as the possible appearance of adverse effects and/or multiresistant pathogens. Controls are based on the assessment of plasma drug concentrations and microbiological surveillance to detect the presence of multiresistant strains or new antibacterial-resistant pathogens. Prevention of the development of multiresistant pathogens is the main goal of the ICU antimicrobial policy. Although a series of general strategies to reduce the presence of multiresistant pathogens have been proposed, the implementation of these recommendations in ICUs requires the cooperation of a member of the intensive care team.  相似文献   

14.
The increasing availability of rapid and sensitive nucleic acid testing assays for infectious diseases will revolutionize the practice of medicine by gradually reducing the need for standard culture-based microbiological methods that take at least two days. Molecular theranostics in infectious diseases is an emerging concept in which molecular biology tools are used to provide rapid and accurate diagnostic assays to enable better initial management of patients and more efficient use of antimicrobials. Essential conditions and the quality control required for the development and validation of such molecular theranostic assays are reviewed.  相似文献   

15.
我国奶牛养殖规模不断扩大,奶业产值比重逐步提高,给奶牛疫病防治带来巨大压力。奶牛乳房炎及细菌性肺炎等呼吸系统疾病和细菌性肠炎等消化系统疾病最为常见,抗菌药物的使用成为主要防治手段。但抗菌药物的不当使用易使细菌产生耐药性,增加临床治疗的成本和难度,危害我国奶牛产业发展。本文对截至2021年7月我国和美国、英国、日本、欧盟批准用于奶牛的抗菌药物产品进行整理、统计与分析,包括抗菌药物的分类、剂型以及适应证等,旨在为我国奶牛用抗菌药物管理、合理用药和新兽药开发提供参考。  相似文献   

16.
Antimicrobial agents are used to treat patients with infectious diseases. Initial antimicrobial compounds originated from natural sources and were generally deemed to be narrow in spectrum. Today, we are in the era of designer drugs that have been specifically developed with current issues in infectious diseases in mind. For example, some new compounds require once daily dosing, have minimal side effects, are active against resistant pathogens and, for some, have a lower propensity for selecting for antimicrobial resistance during patient therapy.  相似文献   

17.
The macrolides     
Erythromycin, which was introduced over 50 years ago, was the first macrolide to be used clinically. "New" macrolides, for the treatment of patients with various infectious diseases, were not clinically introduced until 40 years later. The pharmacokinetic and adverse events profile of erythromycin initially limited its use to an alternative agent for patients with allergy to beta-lactam agents. However, the emergence of atypical and/or new pathogens and the ongoing escalation of acquired antimicrobial resistance has impacted on the empirical and organism directed therapy of infectious diseases. Azithromycin and clarithromycin were developed by enhancing the basic macrolide structure. Some of the basic features associated with these new agents include a pharmacokinetic profiles that allow once or twice daily dosing with a much lower incidence of side effects and a substantially broader spectrum of activity which includes some Gram-negative bacilli, atypical pathogens and new, unconventional or uncommon pathogens. Clinical trial data has supported the use of "new" macrolides in a wide range of clinical indications, however, some specific indications are currently restricted to treatment with either azithromycin or clarithromycin. Macrolide resistance is a class effect and depending on the mechanism will confer either low or high level resistance. While resistance is problematic, it does not always result in clinical failure. The macrolides are a valuable class of antimicrobial agent and play an important role in the management of infectious diseases.  相似文献   

18.
Antimicrobial agents are used to treat patients with infectious diseases. Initial antimicrobial compounds originated from natural sources and were generally deemed to be narrow in spectrum. Today, we are in the era of designer drugs that have been specifically developed with current issues in infectious diseases in mind. For example, some new compounds require once daily dosing, have minimal side effects, are active against resistant pathogens and, for some, have a lower propensity for selecting for antimicrobial resistance during patient therapy.  相似文献   

19.
Human genetic variation is a major determinant of susceptibility to many common infectious diseases. Malaria was the first disease to be studied extensively and many susceptibility and resistance loci have been identified. However, genes for other diseases such as HIV/AIDS and mycobacterial infections are now being identified using a variety of approaches. A large number of genes appear to influence susceptibility to infectious pathogens and defining these can provide insights into pathogenic and protective mechanisms and identify new molecular targets for prophylactic and therapeutic interventions. Immunogenetic associations with infectious diseases have considerable potential to guide immunomodulatory interventions and vaccine design.  相似文献   

20.
Antimicrobial therapies for oral diseases have been in use for centuries, but have undergone rapid changes in the last decade. In the coming years, antimicrobial strategies will become more sophisticated and efficacy will be greatly improved as new therapeutic technologies emerge. New delivery systems for common antimicrobials and novel agents to modulate the immune system, as well as biofilm formation and maturation, may be on the horizon. This review describes the development and the application of intraoral antimicrobial drug delivery in the oral environment. Current clinical uses of antimicrobials as well as future approaches to the treatment and prevention of oral infectious diseases are discussed.  相似文献   

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