Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành hóa học dành cho các bạn yêu hóa học tham khảo đề tài: Colistin: recent data on pharmacodynamics properties and clinical efficacy in critically ill patients | Michalopoulos and Falagas Annals of Intensive Care 2011 1 30 Ù Annals of Intensive Care http content 1 1 30 a SpringerOpen Journal REVIEW Open Access Colistin recent data on pharmacodynamics properties and clinical efficacy in critically ill patients Argyris S Michalopoulos1 2 and Matthew E Falagas2 3 4 Abstract Recent clinical studies performed in a large number of patients showed that colistin forgotten for several decades revived for the management of infections due to multidrug-resistant MDR Gram-negative bacteria GNB and had acceptable effectiveness and considerably less toxicity than that reported in older publications. Colistin is a rapidly bactericidal antimicrobial agent that possesses a significant postantibiotic effect against MDR Gram-negative pathogens such as Pseudomonas aeruginosa Acinetobacter baumannii and Klebsiella pneumoniae. The optimal colistin dosing regimen against MDR GNB is still unknown in the intensive care unit ICU setting. A better understanding of the pharmacokinetic-pharmacodynamic relationship of colistin is urgently needed to determine the optimal dosing regimen. Although pharmacokinetic and pharmacodynamic data in ICU patients are scarce recent evidence shows that the pharmacokinetics pharmacodynamics of colistimethate sodium and colistin in critically ill patients differ from those previously found in other groups such as cystic fibrosis patients. The AUC MIC ratio has been found to be the parameter best associated with colistin efficacy. To maximize the AUC MIC ratio higher doses of colistimethate sodium and alterations in the dosing intervals may be warranted in the ICU setting. In addition the development of colistin resistance has been linked to inadequate colistin dosing. This enforces the importance of colistin dose optimization in critically ill patients. Although higher colistin doses seem to be beneficial the lack of colistin pharmacokinetic-pharmacodynamic data results in difficulty for the
