抗生素活性时程的评估指标:靶组织游离药物的浓度

评价抗生素临床疗效的常用参数包括:最低抑菌浓度(MIC)、抗生素后效应(PAE)以及一些基于MIC的药动学/药效学参数,如t>MIC,cmax/MIC,AUC/MIC等。但由于抗生素的蛋白质结合率不同、组织分布不均匀和各种屏障等因素的影响,上述参数都存在一定的局限性。靶组织游离药物浓度是一个重要的药动学/药效学模型参数,能够更好地说明抗生素的临床疗效。近年来,国内外报道的研究靶点药物分布的方法有很多,其常用方法是利用皮肤水疱研究、成像技术和透析技术测定抗生素在靶组织的分布浓度。总之,新技术的介入提供了更多的靶点药物分布的信息。

The index of evaluating activity time course of antibiotics: free drug concentrations of target tissue

The commonly used parameters of evaluating antibiotic clinical efficacy includes minimal inhibitory concentration(MIC),post antibiotic effect(PAE) and some parameters of pharmacokinetics(PK) and pharmacodynamics(PD) based on MIC such as t>MIC,c_(max)/MIC,AUC/MIC etc.However,antibiotics have different protein-binding rates,uneven tissue distribution and various barriers affecting drug transport,so the parameters mentioned above have certain limitation.Free drug concentration of target tissue(C_(TTF)) is an important parameter for PK/PD model and is more suitable for evaluating antibiotic clinical efficacy than any other parameters.In recent years,many reports dealt with determining the drug distribution in target tissue.The methods often used involved measuring the target concentration by skin blister study,tomography and microdialysis technique.In a word,new technologies have offered more information of antibiotic distribution in target tissue.