The containment of the phenomenon of resistance towards antimicrobials is a priority, especially in preserving molecules acting against Gram-negative pathogens, which represent the isolates more frequently found in the fragile population of patients admitted to Intensive Care Units. Antimicrobial therapy aims to prevent resistance through several actions, which are collectively known as “antimicrobial stewardship”, to be taken together, including the application of pharmacokinetic/pharmacodynamic (PK/PD) principles. PK/PD application has been shown to prevent the emergence of resistance in numerous experimental studies, although a straight translation to the clinical setting is not possible. Individualized antibiotic dosing and duration should be pursued in all patients, and even more especially when treating intensive care unit (ICU) septic patients in whom optimal exposure is both difficult to achieve and necessary. In this review, we report on the available data that support the application of PK/PD parameters to contain the development of resistance and we give some practical suggestions that can help to translate the benefit of PK/PD application to the bedside.

中文翻译：

---

PK/PD 原则对临床环境中遏制耐药性的一些建议——重点关注 ICU 患者和革兰氏阴性菌株


遏制抗菌药物耐药现象是当务之急，特别是在保护针对革兰氏阴性病原体的分子方面，革兰氏阴性病原体代表了在重症监护病房的脆弱患者群体中更常见的分离株。抗菌治疗旨在通过多种措施来预防耐药性，这些措施统称为“抗菌药物管理”，包括应用药代动力学/药效学 (PK/PD) 原则。尽管不可能直接转化为临床环境，但大量实验研究表明 PK/PD 应用可以防止耐药性的出现。所有患者都应追求个体化的抗生素剂量和持续时间，尤其是在治疗重症监护病房 (ICU) 脓毒症患者时，因为最佳暴露很难实现，但又是必要的。在这篇综述中，我们报告了支持应用 PK/PD 参数来遏制耐药性发展的可用数据，并给出了一些实用的建议，有助于将 PK/PD 应用的益处转化为临床。