Abstract：
Intravenous β-lactam antibiotics remain a cornerstone in the management of bacterial infections due to their broad spectrum of activity and excellent tolerability. β-lactams are well established to display time-dependent bactericidal activity, where reductions in bacterial burden are directly associated with the time that free drug concentrations remain above the minimum inhibitory concentration (MIC) of the pathogen during the dosing interval. In an effort to take advantage of these bactericidal characteristics, prolonged (extended and continuous) infusions (PIs) can be applied during the administration of intravenous β-lactams to increase time above the MIC. PI dosing regimens have been implemented worldwide, but implementation is inconsistent. We report consensus therapeutic recommendations for the use of PI β-lactams developed by an expert international panel with representation from clinical pharmacy and medicine. This consensus guideline provides recommendations regarding pharmacokinetic and pharmacodynamic targets, therapeutic drug-monitoring considerations, and the use of PI β-lactam therapy in the following patient populations: severely ill and nonseverely ill adult patients, pediatric patients, and obese patients. These recommendations provide the first consensus guidance for the use of β-lactam therapy administered as PIs and have been reviewed and endorsed by the American College of Clinical Pharmacy (ACCP), the British Society for Antimicrobial Chemotherapy (BSAC), the Cystic Fibrosis Foundation (CFF), the European Society of Clinical Microbiology and Infectious Diseases (ESCMID), the Infectious Diseases Society of America (IDSA), the Society of Critical Care Medicine (SCCM), and the Society of Infectious Diseases Pharmacists (SIDP).
摘要：
静脉内β-内酰胺抗生素由于其广谱的活性和优异的耐受性而仍然是控制细菌感染的基石。β-内酰胺是公认的显示时间依赖性杀菌活性，其中细菌负荷的减少与在给药间隔期间游离药物浓度保持高于病原体的最小抑制浓度(MIC)的时间直接相关。为了利用这些杀菌特性，可以在静脉内施用β-内酰胺的过程中应用延长的(延长的和连续的)输注(PI),以增加超过MIC的时间。PI给药方案已在全球范围内实施，但实施是不一致的。我们报告了由临床药学和医学代表的国际专家小组开发的关于使用PIβ-内酰胺的共识治疗建议。本共识指南提供了有关药代动力学和药效学目标的建议，治疗药物监测考虑因素，以及在以下患者人群中使用PIβ-内酰胺治疗：重症和非重症成人患者，儿科患者,和肥胖患者。这些建议为β-内酰胺治疗作为PIs的使用提供了第一个共识指导，并得到了美国临床药学学会（ACCP）的审查和认可。英国抗菌化疗学会（BSAC），囊性纤维化基金会（CFF），欧洲临床微生物学和传染病学会（ESCMID），美国传染病学会（IDSA），重症监护医学学会（SCCM），和传染病药剂师协会（SIDP）。
