利奈唑胺在重症患者中药动学研究进展

Research Progress on the Pharmacokinetics of Linezolid in Critically Ill Patients

关键词:  利奈唑胺  重症  药动学  治疗药物监测

Key words:  linezolid  critically ill  pharmacokinetics  therapeutic drug monitoring

摘要:

利奈唑胺是使用广泛的抗革兰氏阳性菌药物，本文总结利奈唑胺在重症患者中药动学的主要变化，为利奈唑胺在重症患者中的合理使用提供参考。重症患者中利奈唑胺的吸收和分布并未发生显著变化；肝功能不全、肾功能异常、肾脏替代治疗和体外膜肺氧合等会影响利奈唑胺的清除率，导致治疗浓度发生变化，影响治疗效果。重症患者使用利奈唑胺时，建议实行治疗药物监测，将谷浓度保持在2~8 mg·L^–1，以确保最佳的疗效和安全性。

Abstract:

Linezolid is a widely used anti-Gram-positive bacteria drug. This article summarizes the main changes in the pharmacokinetics of linezolid in critically ill patients, and to provide reference for the rational use of linezolid in critically ill patients. The absorption and distribution of linezolid in critically ill patients do not change significantly; hepatic insufficiency, abnormal renal function, renal replacement therapy and extracorporeal membrane oxygenation can affect the clearance rate of linezolid and cause changes in the therapeutic concentration, thereby affecting the therapeutic effect. It is recommended to implement therapeutic drug monitoring and keep the trough concentration at 2-8 mg·L^-1 to ensure the best efficacy and safety when linezolid is used in critically ill patients.