摘要
氨基糖苷类抗生素主要用于需氧革兰阴性杆菌引起的严重全身性感染,包括胆道感染、骨和关节感染、尿路感染、皮肤及软组织感染等。目前,氨基糖苷类抗生素的主要分析方法有LC-MS/MS和HPLC法,其临床疗效与最高血药浓度/最低抑菌浓度比值成正相关。由于氨基糖苷类药物在临床应用中具有较强的耳、肾毒性等,常选择较低的给药剂量,可能导致其达不到临床疗效。同时,该类药物毒性主要与氧化应激有关,但具体机制仍不明确。本文综述该类药物的药动学/药效学特点、常用检测方法及其耳、肾毒性机制和减毒机制,以期为临床治疗药物监测、合理用药及相关实验研究提供参考。
Aminoglycoside antibiotics are mainly used for severe systemic infections caused by aerobic Gram-negative bacilli,including biliary tract infections,bone and joint infections,urinary tract infections,skin and soft tissue infections.The current analytic methods of aminoglycoside antibiotics include LC-MS/MS and HPLC.The clinical efficacy is positively correlated with the peak concentration/minimal inhibitory concentration.However,aminoglycoside antibiotics have strong ototoxicity and neph⁃rotoxicity in clinical application so that the lower dose is often selected,which may lead to ineffective⁃ness.The toxicity mechanism of aminoglycoside antibiotics is mainly related to oxidative stress,but it is far from clear.Therefore,it is urgent to stay up-to-date with the research progress in pharmacokinetics/pharmacodynamics,the common detection methods,ototoxicity,nephrotoxicity and the detoxification mechanism of aminoglycosides,in order to provide reference for clinical therapeutic drug monitoring,ratio⁃nal drug use and related experimental research.
作者
邓阳
肖亦莎
李昕
徐兵
黄珺晨
DENG Yang;XIAO Yi-sha;LI Xin;XU Bing;HUANG Jun-chen(Department of Pharmacy,the Third Hospital of Changsha,Changsha 410015,China;Clinical Application Research Institute of Antibiotics in Changsha,Changsha 410015,China;School of Pharmacy,Changsha Medical University,Changsha 410219,China)
出处
《中国药理学与毒理学杂志》
CAS
北大核心
2019年第12期1085-1092,共8页
Chinese Journal of Pharmacology and Toxicology
基金
湖南省感染性疾病临床合理用药技术示范基地项目(2016SK4008)
湖南省自然科学基金(2019JJ50680)
长沙市科技计划项目(kq1801123)
长沙市科技计划项目(kq1801120)。
关键词
氨基糖苷类抗生素
治疗药物监测
耳毒性
肾毒性
药动学
药效学
aminoglycoside antibiotics
therapeutic drug monitoring
ototoxicity
nephrotoxicity
pharmacokinetics
pharmacodynamics
