慢性肾衰竭时的抗生素调整

慢性肾功能不全(CRI)对抗生素的吸收、分布、代谢和肾脏清除产生影响，导致血液中药物或其代谢产物蓄积和由此引起的并发症，例如肾脏、肝脏、骨髓和神经系统等毒性。CRI病人应用抗生素时需要根据其药代动力学调整剂量。最安全的药物调整方法是参考药物治疗学专著；对于新药或专著中没有涉及的药物可参阅相关文献；如果上述方法无效，可用公式推算。由于药代动力学存在个体差异，无论使用何种方法，都应当注意进行不良反应监测，必要时进行血药浓度或游离血药浓度监测。

Dosage adjustment of antibiotics in chronic renal failure

Chronic renal insufficiency disturbs antibiotics absorption,distribution,metabolism and renal clearance,which causes accumulation of antibiotics and/or its metabolites and related symptoms,such as toxic effects of kidney,liver,bone marrow and nervous system.Dosage of antibiotics should be adjusted according to antibiotics pharmacokinetics.To adjust antibiotic dosage according to textbook is the safest method;as to new antibiotics or those not discussed in textbook,literature review is preferred,if dosage of an special antibiotic can not be determined by above mentioned methods,formula can be used. Side effects of antibiotic and/or its metabolites accumulation should be monitored,total serum concentration or free drug concentration should be monitored because of the pharmacokinetics difference between individuals.