Antibiyotiklerde Terapötik İlaç Düzeyi İzlemi

Terapötik ilaç düzeyi izlemi; kan ve diğer vücut sıvılarında bulunan ilaç konsantrasyonlarının ölçülmesi işlemidir. Terapötik ilaç düzeyi izlemi hastanın yaş, kilo, genetik özellikler, çevresel faktörler, böbrek ve karaciğer fonksiyonları ile kullanılan diğer ilaçlarla etkileşim gibi durumlar değerlendirilerek uygun doz ve dozaj formunun seçimi ile başlar. Tedavide kullanılan ilacın kararlı durum konsantrasyonuna ulaşma zamanı, örnek toplama zamanı, toplanacak örnek sayısı, laboratuvar ölçümleri, analiz sonuçların yorumlanması gibi bir dizi işlemden oluşan bir süreci kapsar. Enfeksiyon tedavisinde antibiyotik ilaçlardan en az toksisite ile en uygun etkinliğin sağlanması önemli bir adımdır. Bu durumun sağlanması patojen bakterinin duyarlılığı ile kullanılan antibiyotiğin farmakokinetik özelliklerinin birlikte değerlendirildiği bir anlayışı gerektirir. Kan ve diğer vücut sıvılarında antibiyotik konsantrasyonlarının izlenmesi genellikle aminoglikozidler ve vankomisin gibi dar terapötik indekse sahip ilaçlar için kullanılmaktadır. Ancak son yıllarda öncelikli hedef toksisiteyi önlemekten ziyade ilaç etkinliğini artırmak haline gelmiştir. Bu derlemede enfeksiyon tedavisinde terapötik ilaç düzeyi izlemi kullanılmasının önemine değinilmiştir.

Anahtar Kelimeler:

Antibiyotik, Farmakokinetik, Farmakodinamik, Terapötik İlaç İzlemi

Therapeutic drug monitoring of antibiotics

Therapeutic drug level monitoring; is the process of measuring drug concentrations in blood and other body fluids. Therapeutic drug level monitoring begins with the selection of the appropriate dosage and dosage form by evaluating the patient's age, weight, genetic characteristics, environmental factors, kidney and liver functions, and interactions with other drugs used. It covers a process consisting of a series of procedures such as the time to reach a steady-state concentration of the drug used in treatment, sample collection time, number of samples to be collected, laboratory measurements, and interpretation of analysis results. It is an important step to provide the most effective activity with the least toxicity among the antibiotic drugs in the treatment of infection. Achieving this situation requires an understanding that the sensitivity of the pathogen bacteria and the pharmacokinetic properties of the antibiotic used are evaluated together. Monitoring antibiotic concentrations in blood and other body fluids are often used for drugs with a narrow therapeutic index, such as aminoglycosides and vancomycin. However, in recent years, its primary goal has been to increase drug effectiveness rather than prevent toxicity. In this review, the importance of using therapeutic drug level monitoring in the treatment of infection is mentioned.

Keywords:

Antibiotic, Pharmacokinetic, Pharmacodynamic, Therapeutic Drug Monitoring,

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