优化静脉注射吸毒者的抗生素治疗:药代动力学/药效学挑战:叙述性综述》。

IF 1.9 4区 医学 Q3 PHARMACOLOGY & PHARMACY
Marta Colaneri, Camilla Genovese, Pietro Valsecchi, Matteo Calia, Dario Cattaneo, Andrea Gori, Raffaele Bruno, Elena Seminari
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引用次数: 0

摘要

静脉注射吸毒者(IVDUs)更容易受到革兰氏阳性细菌感染,尤其是耐甲氧西林金黄色葡萄球菌(MRSA),从而危及生命。众所周知,针对肥胖或危重病人等特殊患者的标准抗生素剂量策略是不够的,这引起了人们对治疗效果的担忧,但目前还没有针对 IVDU 进行类似的评估。有鉴于此,本综述研究了 IVDU 中常用的抗革兰氏阳性菌抗生素的药代动力学/药效学特征。研究重点关注达托霉素、万古霉素、替考拉宁、氨基糖苷类和新型脂糖肽达巴万星,结果显示 IVDU 的药代动力学存在显著差异,表明需要个性化用药。同时进行的阿片类药物替代治疗和营养不良等其他因素会导致药代动力学/药效学的改变,这就强调了有针对性的治疗药物监测的重要性。总之,我们的研究呼吁临床医生提高对 IVDU 独特的药代动力学/药效学挑战的认识,并倡导量身定制的抗生素剂量策略,以提高这一边缘人群的治疗效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Optimizing Antibiotic Therapy for Intravenous Drug Users: A Narrative Review Unraveling Pharmacokinetics/Pharmacodynamics Challenges.

Intravenous drug users (IVDUs) face heightened susceptibility to life-threatening gram-positive bacterial infections, particularly methicillin-resistant Staphylococcus aureus (MRSA). While the standard antibiotic dosing strategies for special patients, such as obese or critically ill individuals, are known to be inadequate, raising concerns about treatment efficacy, a similar sort of understanding has not been assessed for IVDUs yet. With this in mind, this review examines the pharmacokinetic/pharmacodynamic characteristics of antibiotics commonly used against gram-positive bacteria in IVDUs. Focusing on daptomycin, vancomycin, teicoplanin, aminoglycosides, and the novel lipoglycopeptide dalbavancin, the study reveals significant pharmacokinetic variations in IVDUs, suggesting the need for personalized dosing. Concomitant opioid substitution therapy and other factors, such as malnutrition, contribute to altered pharmacokinetics/pharmacodynamics, emphasizing the importance of targeted therapeutic drug monitoring. Overall, our study calls for increased awareness among clinicians regarding the unique pharmacokinetic/pharmacodynamic challenges in IVDUs and advocates for tailored antibiotic dosing strategies to enhance treatment outcomes in this marginalized population.

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来源期刊
CiteScore
3.70
自引率
0.00%
发文量
64
审稿时长
>12 weeks
期刊介绍: Hepatology International is a peer-reviewed journal featuring articles written by clinicians, clinical researchers and basic scientists is dedicated to research and patient care issues in hepatology. This journal focuses mainly on new and emerging diagnostic and treatment options, protocols and molecular and cellular basis of disease pathogenesis, new technologies, in liver and biliary sciences. Hepatology International publishes original research articles related to clinical care and basic research; review articles; consensus guidelines for diagnosis and treatment; invited editorials, and controversies in contemporary issues. The journal does not publish case reports.
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