[以药代动力学靶点为指导的成人静脉万古霉素治疗]。

IF 0.8 4区 医学 Q3 MEDICINE, GENERAL & INTERNAL
Lili Holub, Gellért Balázs Karvaly, Lőrinc Závorszky, Katalin Kristóf, Ákos Tóth, Kinga Tóth, Boglárka Lovász, Csaba Kassa, Barna Vásárhelyi, Botond Lakatos, Bálint Szabó
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引用次数: 0

摘要

耐多药病原体和具有长期抗微生物药物耐药性的病原体给卫生保健系统造成了严重负担。引入抗感染治疗方案,灵活地确保有效治疗和抑制病原体耐药菌株的进化已成为一项紧迫的任务。治疗性药物监测(TDM)是近年来发展成为多学科交叉领域的重要技术。万古霉素在世界范围内用于住院病房,用于怀疑或记录由革兰氏阳性病原体引起的感染。目前普遍接受的万古霉素治疗严重MRSA感染的共识建议详细介绍了万古霉素在TDM之外的临床应用在不同患者群体(危重患者、肥胖患者和接受肾脏替代治疗的患者)中的应用。基于现有的指导方针和可用的计算器软件,治疗可以从最关键的早期阶段个性化。我们的目标是总结共识指南中制定的观点和建议,将其整合到随后的科学出版物中,并促进其临床实施,使我们更接近匈牙利的协调实践。我们还旨在介绍使用万古霉素药代动力学计算器的观点。最后,我们对成人护理中万古霉素治疗的个性化决策提出方法学建议。Orv Hetil. 2025;166(17): 638 - 651。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Intravenous vancomycin therapy of adults guided by pharmacokinetic-pharmacodynamic targets].

Multidrug-resistant pathogens and those with extended antimicrobial resistance significantly burden the healthcare system. The introduction of anti-infective therapy protocols that flexibly ensure effective treatment and the suppression of the evolution of resistant strains of pathogens has become an urgent task. Therapeutic drug monitoring (TDM), which has recently developed into a multidisciplinary field, makes a significant contribution. Vancomycin is used worldwide in inpatient wards for suspected or documented infections caused by Gram-positive pathogens. The currently generally accepted consensus recommendation for the treatment of severe MRSA infections with vancomycin presents in detail the aspects of the clinical use of the drug in addition to TDM for different patient populations (critically ill, obese, and patients receiving renal replacement therapy). Based on existing guidelines and available calculator software, treatment can be individualized from its most critical early stage. We aim to summarize the views and recommendations formulated in the consensus guideline, integrate these into subsequent scientific publications, and facilitate their clinical implementation to take us closer to a harmonized practice in Hungary. We also aim to present the perspectives of using vancomycin pharmacokinetic calculators. Finally, we make methodological recommendations for individualized decisions regarding vancomycin therapy in adult care. Orv Hetil. 2025; 166(17): 638–651.

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来源期刊
Orvosi hetilap
Orvosi hetilap MEDICINE, GENERAL & INTERNAL-
CiteScore
1.20
自引率
50.00%
发文量
274
期刊介绍: The journal publishes original and review papers in the fields of experimental and clinical medicine. It covers epidemiology, diagnostics, therapy and the prevention of human diseases as well as papers of medical history. Orvosi Hetilap is the oldest, still in-print, Hungarian publication and also the one-and-only weekly published scientific journal in Hungary. The strategy of the journal is based on the Curatorium of the Lajos Markusovszky Foundation and on the National and International Editorial Board. The 150 year-old journal is part of the Hungarian Cultural Heritage.
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