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antibiotic treatment on respiratory tract infecti新的抗生素治疗上呼吸道感染课件
Levofloxacin Steady-state concentrations (after 2 days of therapy) in critically ill patients with severe community-acquired pneumonia Bosselli et al. Crit Care Med 2005; 33:104-9 Forrest et al. Antimicrob Agents Chemother 1993; 37:1073-81 AUC : MIC 125 Ciprofloxacin (200 mg/12 h – 400 mg/8 h i.v.) clinical and microbiological outcome in critically ill ICU patients with Gram negative infections Ciprofloxacin 9* 10 16 7 22 *number of patients AUC : MIC 33.7 Levofloxacin (500 mg/24 h) clinical and microbiological outcomes in patients with community acquired S. pneumoniae respiratory tract infection Levofloxacin Ambrose et al. Antimicrob Agents Chemother 2001; 45:2793-7 Probability of target attainment (AUC:MIC 33.7) for levofloxacin (500 mg/24 h, orally) in patients with community acquired Streptococcus pneumoniae respiratory tract infections Classification and Regression Tree (CART) analysis Ambrose et al. Antimicrob Agents Chemother 2001; 45:2793-7 Levofloxacin * Bacteria have evolved numerous mechanisms to evade antimicrobial drugs. Chromosomal mutations are an important source of resistance to some antimicrobials. Acquisition of resistance genes or gene clusters, via conjugation, transposition, or transformation, accounts for most antimicrobial resistance among bacterial pathogens. These mechanisms also enhance the possibility of multi-drug resistance. * * * Para comprender la efectividad de un medicamento y poder conseguir su eficacia máxima en cada situación debemos conocer también sus cualidades farmacocinéticas y farmacodinámicas. La velocidad con que se absorbe el preparado nos indica cuanto tiempo tardará en comenzar su acción. El tiempo que tarda en conseguir la máxima concentración en sangre (tmax)nos orientará en este sentido. hasta hace pocos a?os las infecciones graves se identificaban con la terapia intravenosa ya que los fármacos se absorbían de forma imprecisa y lentamente. Hoy diversos antibióticos modernos -entre lo
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