João Gonçalves Pereira *

Autor invitado por SIIC

Contribuição para a optimização da apropriação antibiótica

UTILIDADE DA PERFUSÃO CONTÍNUA DE ANTIBIÓTICOS

A actividade bactericida depende não só da correcta selecção de antibióticos face aos prováveis microorganismos infectantes (adequação), mas igualmente do emprego de relações concentração-tempo adequadas ao seu perfil farmacodinâmico (apropriação). Nos antibióticos tempo-dependente a perfusão contínua maximiza o efeito bactericida ao possibilitar que a sua concentração esteja permanentemente acima da concentração inibitória mínima bacteriana.

*João Gonçalves Pereira
describe para SIIC los aspectos relevantes de su trabajo
ANTIBIÓTICOS EM PERFUSÃO CONTÍNUA
Institución principal de la investigación
*Hospital S. José, Lisboa, Portugal, Lisboa, Portugal
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Referencias bibliográficas
Fridkin SK. Increasing prevalence of antimicrobial resistance in intensive care units. Crit Care Med 2001; 29 (Suppl.): N64-N68.Liu P, Muller M, Derendorf H. Rational dosing of antibiotics: the use of plasma concentration versus tissue concentrations. International Journal of Antimicrobial Agents; 2002; 19: 285-290.Mouton JW. Impact of pharmacodynamics on breakpoint selection for susceptibility testing. Infect Dis Clin N Am 2003; 17: 579-598.Kollef MH. Inadequate antimicrobial treatment: an important determinant of outcome for hospitalized patients. Clin Infect Dis 2000; 31 (Suppl 4):S131-S138.Kollef MH, Sherman G, Ward S, Fraser VJ. Inadequate antimicrobial treatment of infections. A risk factor for hospital mortality among critically ill patients. Chest 1999; 115:462-474.Drusano GL. Prevention of resistance: A goal for dose selection for antimicrobial agents. Clin Infect Dis 2003; 36 (Suppl 1): S42-S50.DeLisle S, Perl TM. Antimicrobial management measures to limit resistance: A process-based conceptual framework. Crit Care Med 2001; 29 (Suppl.): N121-N127.Craig WA. Pharmacokinetic/Pharmacodynamic parameters: Rational for antibacterial dosing of mice and men. Clin Infect Dis 1998; 26:1-12.Liu P, Derendorf H. Antimicrobial tissue concentrations. Infect Dis Clin N Am 2003; 17:599-613.Schetz M, Ferdinande P, Van den Berghe G, Verwaest C, Lauwers P. Pharmacocinetics of continuous renal replacement therapy. Intensive Care Med 1995; 21:612-620.Joukhadar C, Frossard M et al. Impaired target site penetration of beta-lactams may account for therapeutic failure in patients with septic shock. Crit Care Med 2001; 29:385-391.Gunderson BW, Ross GH, Ibrahim KH, Rotschafer JC. What do we really know about antibiotic pharmacodynamics Pharmacoterapy 2001; 21 (11s): 302s–318s.Hyatt JM, McKinnon PS, Zimmer GS, Schentag JJ. The Importance of pharmacocinetic/pharmacodynamic surrogate markers to outcome. Focus on antibacterial agents. Clin Pharmacokinet 1995; 28 (2): 143-60.Craig WA. Basic pharmacodynamics of antibacterials with clinical applications to the use of beta-lactams, glycopeptides, and linezolid. Infect Dis Clin N Am 2003; 17: 479-501.Bodey GP, Ketchel SJ, Rodriguez V. A randomized study of carbenecilin plus cefamandole or tobramycin in the treatment of febrile episodes in cancer patients. Am J Med 1979; 67 (4):608-616.MacGowan AP, Bowker KE. Continuous infusion of beta-lactam antibiotics. Clin Pharmacokinet 1998; 35 (5):391-402.Brook I. Inoculum effect. Rev Infect Dis 1989; 11:361-368.Vondracek TG. Beta-lactam antibiotics: is continuous infusion the preferred method of administration Ann Pharmacother 1995; 29: 415-424.Mouton JW, Vinks AA. Is continuous infusion of beta-lactam antibiotics worthwhile – efficacy and pharmacokinetic considerations. J Antimicrob Chemother 1996; 38:5-15.Wysocki M, Delatour F et al. Continuous versus intermittent infusion of vancomycin in severe Staphylococcal infections: Prospective multicenter randomized study. Antimicrob Agent Chemother 2001; 45 (9):2460-2467.Servais H, Tulkens PM. Stability and compatibility of ceftazidime administered by continuous infusion to intensive care patients. Antimicrob Agent Chemother 2000; 45 (9):2463-2467.Bryan CS. Treatment of pneumococcal pneumonia: The case for penicillin G. Am J Med 1999; 107 (1A):63S-68S.Thauvin C, Eliopoulos GM, Willey S, Wennersten C, Moellering RC. Continuous-infusion ampicillin therapy of enterococcal endocarditis in rats. Antimicrob Agents Chemother 1987; 31 (2):139-43.Grant EM, Kuti JL, Nicolau DP, Nightingale C, Quintiliani R. Clinical efficacy and pharmacoeconomics of a continuous-infusion piperacillin-tazobactam program in a large community teaching hospital. Pharmacotherapy 2002; 22 (4):471-83.James JK, Palmer SM, Levine DP, Rybak MJ. Comparison of conventional versus continuous-infusion vancomycin therapy for patients with suspected or documented gram-positive infections. Antimicrob Agent Chemother 1996; 40 (3):696-700.

Otros artículos de João Gonçalves Pereira

Gonçalves Pereira J. Antibioterapia da pneumonia; A emergência das resistências. Infecções Respiratórias (aceite para publicação).Gonçalves Pereira J, Bentes de Jesus M. Toxicodependentes internados numa enfermaria de medicina interna: Relato de uma experiência. Medicina Interna; Vol. 11, N.2, 2004.

Para comunicarse con João Gonçalves Pereira mencionar a SIIC como referencia:
joao.gp@netcabo.pt

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Acerca del trabajo completo

UTILIDADE DA PERFUSÃO CONTÍNUA DE ANTIBIÓTICOS

Título original en castellano
ANTIBIOTICOS EM PERFUSÃO CONTINUA

Autor
João Gonçalves Pereira¹
1 Médico, Hospital S. José, Assistente Hospitalar

Acceso a la fuente original
Revista Portuguesa de Medicina Intensiva
http://www.spci.org/frames/rev.html

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