课件：ESBLs的耐药机制及抗菌药物应用原则.pptVIP

对肠杆菌科细菌抗生素的选择要点（小结） 对肠杆菌科细菌抗生素的选择要点（小结） 抗菌药物 适应人群 美罗培南 亚胺培南 头孢哌酮/舒巴坦 哌拉西林/他唑巴坦 头孢他啶 头孢吡肟 头孢三嗪 重症、免疫抑制、存在ESBLs高危因素患者的首选 ?非重症、非免疫抑制的ESBLs高危因素患者 ?碳青霉烯类有效后的替换 非ESBLs高危因素、社区非重症患者 ?针对大肠：美平 0.5~1.0 q8h 可以单用 ?针对肺克：美平 1.0 q8h ~ q6h 必要时可联合氨基糖苷或氟喹诺酮类 谢谢 THANK YOU SUCCESS * * 可编辑 * 大家好,关于CFCCS项目的具体培训工作内容作一介绍 * This slide represents key factors involved in antimicrobial therapy. Once the dose is administered, pharmacokinetic parameters then describe what happens to the drug once it enters the body. Absorption from the GI tract is essential for oral therapy. Once in the blood stream critical factors for success include distribution of the drug into the infected tissues. How long a drug remains in the blood stream is determined by half-life (metabolism or excretion) The distribution and metabolism of the drug can have an impact on safety (hepatic metabolites) or efficacy (urine excretion unchanged for UTI). The degree of protein binding can impact the microbiologic activity Pharmacodynamics represents the relationship between the pharmacologic activity (MIC) and pharmacokinetics (AUC or peak concentrations). The pharmacologic activity of an antibiotic can be defined by whether they are time-dependent, (effect can be predicted by time above the MIC, or concentration dependent - higher the concentration the greater the bacterial killing) as defined by peak:MIC or AUC:MIC ratios. In addition, post antibiotic effect (PAE) or the continued bacterial killing when the antibiotic blood level fall below the MIC can also impact efficacy. Pharmacologic effect can be determined by a decline in bacterial colony counts which is typically observed in in vitro models. Mortality rates in animal studies is another endpoint and finally in human trials, resolution of signs and symptoms of an infection typically determines clinical success rates. * * 二、当今对 ESBLs 临床有效抗生素的认识 Pitout JDD. Drugs 2010; 70 (3): 313-333 碳青霉烯类 酶抑制剂复合剂 头孢他