アミノ配糖体薬剤の新しい使い方と聴器毒性
スポンサーリンク
概要
- 論文の詳細を見る
Aminoglycoside antibiotics (AGs) are used in the treatment of serious infections with gram-negative bacilli or with staphylococci. Their major limitations are their nephro-and ototoxic side effects.The daily dose has generally been administered to patients in two or three divided doses or continuous infusions. Such regimens were originally devised to avoid excessively high peak serum concentrations that were feared to be toxic.The relationship between pharmacodynamic characteristics of serum concentrations and the ototoxicity of AGs is complex and multifactorial, but in recent years, the risk of ototoxicity has been considered to be related not to peak but to trough serum concentrations. Therefore, the risk of ototoxicity would be minimized with lower trough serum concentrations. Less frequent administrations produce lower trough serum concentrations.On the other hand, it has been clarified that the rate of bactericidal activity of AGs is concentration-dependent, i.e. higher concentrations result in a faster and greater reduction in the number of bacteria. Moreover, AGs induce prolonged postantibiotic effects against gram-positive and gram-negative bacilli.On the basis of this information, it seems that less frequent doses of AGs may be feasible and even advantageous, and a once-daily dosage regimen has been evaluated experimentally and clinically.We believe that once-daily dosing with high peak serum concentrations is less toxic than divided intermittent doses or continuous infusions. The toxicity and efficacy of a once-daily dosage regimen should be evaluated by further experimental studies and clinical trials.
- 耳鼻咽喉科臨床学会の論文
著者
関連論文
- 福島医大における複数科の協力による顔面骨骨折の治療 : 特に頬骨骨折について (自信を持って勧められる我が科の最新医療技術)
- 咽後膿瘍が疑われた咽後リンパ節炎の小児例
- 鼓膜正常例における乳突蜂巣発育と中耳腔炎症所見の局在性との関係 : ヒト側頭骨病理組織学的研究
- ヒト側頭骨乳突蜂巣含気腔の表面積に関する組織学的検討
- 中耳疾患に対するマルチスライスCTの有用性(第二報)
- 蝶形骨洞真菌章の症例と文献的考察
- 声門上狭窄を来した瘢痕性類天疱瘡の1例
- 側頭骨領域におけるマルチスライスCTの有用性について
- 乳突洞天蓋より波及し硬膜下膿瘍をきたした真珠腫性中耳炎の1症例
- 鼓室形成術時に認められたパール状顔面神経由来腫瘤