Effect(PAE) ［ 1 ］s mean after the antibiotics germ and the antibiotics brief contact, be a medicine density to descend low after lowestly suppressing a germ density(MIC) or removing, germ of the growth is still kept on a low-key effect.It the clinical meaning lie in, before design antibiotics only depended on blood medicine density, cancellation velocity and organization to distribute to the medicine project etc. some dynamics datas made a reference, neglected medicine to breed the influence of regulation to the germ growth, but PAE theories point out, make sure antibiotics of give medicine partition should according to medicine density exceed MIC or lowest disinfect time of density(MBC) to plus keep on of PAE time, can prolong time thus to the medicine partition, reduce medicine quantity, have since don’t influence curative effect and can lower the function that the medicine badly responds.The PAE has become an evaluation currently new of antibiotics, design the reasonable is to the important reference value of the medicine project.
The 1 PAE output mechanism
Cause PAE to really slice a mechanism concerning the antibiotics currently still not explicit, stay at the further thorough quest, one of its theories is an antibiotics and the germ brief contact, can cause a germ don’t cause death sex harm, or antibiotics and germ Ba keep on sex combine and cause germ instauration the rebirth prolong with long hours.The two of the theorieses are the Cu white cell effect(PALE)s after the antibiotics, fasten to point after antibiotics and germ get in touch with, the germ body transform, is gobbled up cell easily to identify, and promote to gobble up tend of cell to turn and release to dissolve Mao body’s Mao’s etc. to disinfect material, produce antibiotic and white cell to be in conjunction with a function, make the germ harm aggravate thus, repair time to prolong ［ 2 ］s.The three of the theorieses are an adaptability to bear a medicine and fasten to point antibiotics and germ after get in touch with can appear briefly to for the second time get in touch with the effect that the function die down of the disinfect of medicine, in the medicine function presented to quickly disinfect a function in the early years, after it is for a slow-moving sex adaptability bear medicine process, was a germ to again contact the medicine, it disinfected a function to die down to even disappear.When germ and medicine escape from contact after, its sensitivity to the medicine can recover again.
The clinical meaning with 2 PAEs
PAE clinical meaning mainly is help a clinical doctor design the best include to the medicine project appropriate extension to medicine partition time, change keep on the vein pound at therapy, improvement for the big amount of to the medicine antibiotics clinical use an of medicine quantity and method etc..
2.1 appropriate extensions give medicine partition for time antibiotics of make decision for medicine partition time and it T1/T2, have have no PAE and it time length and disinfect whether function has density dependence or not.When the normal occurrence of the immunity function infect, the blood medicine density also had no occasion for to always maintain at the MIC or the MBC on.At the assurance give medicine partition, can according to the blood medicine density exceed MIC or MBC for time plus time of keep on of PAE to certain.When adopt two kinds of antibiotic consociations used a medicine project, PAE than use time alone more long, hint the PAE has mutually add of a certain degree sex, can prolong partition time is to the medicine.
2.2 improvements for measure for maintaining a stable blood medicine a density, clinical often keep on vein to the medicine, not only the sufferer be hard to accept, also give clinical bring inconvenience.The characteristics learned according to the efficacy of medicine can is divided into density dependence and time to the antibiotics dependence 2 type, the dissimilarity antibiotics has different PAE ［ 3 ］s and be an antibiotic density is big at the MIC can immediately test to find out PAE, great majority antibiotics with density increment the PAE also prolong, then present density dependence ［ is 4 ］s.The research expresses that the intermittent vein drop notes to the medicine or big amount of pound at therapy, equally can attain even better than keep on the vein is to the curative effect of the medicine, and bad reaction have to lower, express that the big amount of can increase organization to wear deeply dint and infect organization in antibiotics of density and efficacy of medicine.Penicillin and head Bao germ plain type the general T1/T2 be short, the cancellation is in a row quick, often adopt slow-moving vein drop to note a project before, currently but lay claim to fast vein drop to note.Big ester inside the wreath, the fluorine Mao promise Tong etc. because the PAE is longer, all can consider once/the d be safe and valid of give a medicine project.
3 antibiotic PAE clinical applications
3.1 Mao An antibiotics inside the of the Mao An β inside the βs for breed a period quickly fungicidal, but its cancellation speed be quick, the T1/T2 is short, before much adopt in a row to medicine or on the first for many times to the medicine.Because it expects cell wall the in a short time of the formation just in the cell division valid, disinfect curative effect to be decided by a blood medicine Gao Di of the density, so have a higher blood medicine a density in the in a short time to treatment beneficial.Combine PAE currently, the assertion adopts fast vein drop to note to the medicine project and dissolve a medicine density of quantity in lose a liquid about the 100 mls in, at the 0.5 hs~drop inside the 1 h be over, can immediately reach a higher blood medicine a density an exaltation curative effect in the in a short time, and then can reduce the companion medicine decomposition but creation of with the result that quick material.Adopt once/the d can’t neglect sufferer the influence of the oneself factor upon the medicine treatment effect for medicine project, first with the result that the germ wants to the antibiotic high sensitive which chooses to use, secondly the sufferer have to have normal immunity function and have normal absorption, metabolize to the Mao An in the β antibiotics, excrete, and have to goodly obey sex, use once on this foundation/the d is feat to the medicine project.
3.2 the ammonia Ji sugar Mao ammonia Ji sugar Mao the antibiotics belong to static period disinfectant, have a good and anti-virus function to aerobic Ge orchid feminine gender rod bacteria and staphylococcus etc., but because of it obvious of ear, kidney toxicity, the clinical application is subjected to restriction.According to the type’s medicine is for the anti-virus medicine of the density dependence, have longer PAE and can induce germ adaptability to bear a medicine etc. the efficacy of medicine learn a characteristics, put forward to once a day measure to the medicine project, can strengthen organization to wear deeply dint and infection organization in antibiotics of density, curative effect, in the meantime because the valley density lower, can reduce its ear, kidney toxicity…etc. badly respond of incidence rate, repress a creation of bear the medicine germ.With tradition on the first for many times compare curative effect to the medicine is equal at least, safety homology or better, the medical expense lower, treatment medicine monitor more convenient, worthy of extend further, the clinical trial verifies its usefulness and safety ［ 5 ］s.Because the ammonia Ji sugar Mao is antibiotic main the prototype be excrete by kidney, past the kidney function be bad, should not adopt once/d of to the medicine project, and want to notice a bear of sufferer to be subjected to sex.
3.2.1 celebrate a big mildewed plain muscle to inject or after the vein intravenous drop 30 mins~the 60 min blood medicine the density reach high peak, the T1/T21.8 hs~3.5 hs, adult a vein intravenous drop 80 mgs, the average blood medicine Feng density can reach to a 4 mgs/L~6 mgs/L the ［ be 6 ］s.This article has 40% inside 24 hs after inject~60% medicine prototypes excrete from the urine.
3.2.2 the rice card star recently research express, strong or weak and of the rice card star function measure into a direct proportion, poisonous side effect incidence rate with use medicine number of times direct proportion ［ 7 ］s.According to rice card the star have PAE and density dependence to disinfect an effect characteristics, the whole day amount of single time after give the medicine excretes the half- life opposite decrease, total clearance rate increment, so its ear, the kidney toxicity opposite decrease, use the whole day amount of of the 15 mgs/kg single time to have very big medicine to get in touch with an effect for the very first time with the medicine, clinical acquire satisfied curative effect.
3.2.3 Nais are for rice star Sun Shu2 Juan wait experiment support Nai do for the rice star once/the d be 8 ］s for medicine ［ , namely the Nai obviously goes up for the Feng density which measure a single time to measure 2 times to the medicine than the whole day to the medicine of the rice star whole day, and Feng disinfect live Gao inside body in 2 times to the medicine, the valley density is all low at 2 μ g/mls.
3.ester antibiotics inside ester inside the 3 greatest wreaths big wreath belong to a growth period to suppress a germ, the research discovers ［ 9 ］s big ester inside the wreath at the medicine density equal or big at the MIC would appear a PAE effect, and 5~10 MICs the PAE be the most long.According to the characteristics of this kind of medicine PAE, at the assurance give medicine partition, can exceed time of MIC or MBC to plus time of keep on of PAE according to the blood medicine density to certain.Clinical medium can adopt once/d of safe effectively to the medicine project.There is report way ［ 10 ］s with the erythromycin 300 mgs, once/d and 150 mgs, 2 times/d 2 kinds give medicine method the contrast cure various infection, result curative effect homology, and have good stomach and intestines system to bear to be subjected to sex.This kind of antibiotics once/the d should notice for medicine:With the result that germ to the antibiotics which chooses to use have to high sensitive;The sufferer’s liver, kidney function have to be normally;Generally and only be limited by the ball germ of Ge Lanyang, army corps germ and pay original body or the dress original body infect.
3.4 fluorine Mao promise Tong fluorine Mao promise Tongs belong to disinfectant, anti-virus table wide, remove a half- life long, present density dependence with PAE relation, at must PAE value inside the scope and density present line sexual behavior, with the increment PAE of the density value enlarge.The anti-virus effect which follows the fluorine Mao promise Tong depend on in to medicine the theories basis which measure this to have something to do with PAE, say to the fluorine Mao promise Tong medicine which has longer PAE at the clinical top, use the whole day amount of single time to have widespread and clinical meaning for medicine.According to the report way, wreath C sand star, oxygen fluorine sand star, Pei fluorine sand star, fluorine the density of sand star and the Luo beautiful sand star at MIC, its PAE is a 1 h~2 hs, each medicine to the PAE ratio of E. coli to golden color staphylococcus long, grow most by the wreath C sand star and the oxygen fluorine sand star particularly among them.If when the density is a 6 mgs/ml, the PAE of each medicine can keep on a 1 h~2 hs, the density in urine is obviously high at the MIC of most cause germ, and medicine’s disinfecting a density in the urine can keep on to reach to a 48 hs above.Therefore, the star 800 mgs/d of the fluorine Mao promise Tong promise fluorine sand or the 500 mgs/d of the wreath C sand star rapy(treat the distance 3 ds~5 ds) used for cure pure sex bladder inflammation and the 400 mgs/d of the oxygen fluorine sand star~the 800 mgs/d used for tuberculosis of treatment method already to clinical expand ［ 11 ］s.Left oxygen fluorine sand star to the PAE of copper green and false single afterbirth germ can reach to a 4 hs above, and the T1/T2 be longer, past treatment this germ infection adopt once/d to medicine then the ［ be 12 ］s, but to various serious and complicated germ infection, adopt once/d to the curative effect of the medicine and bear to be subjected to sex to still stay at the further observation.The fluorine Mao promise Tong is mainly excrete by the liver metabolism and the kidney, the past liver, kidney function are bad, should not adopt once/the d is to the medicine project.
3.5 other different smoke Pians, benefit blessing be even in the anti- tubercle the germ, mostly adopt a whole day a quantity list this to the method of medicine and have of still lay claim to adopt the second total amount following day method for take.Because the rod bacteria replication of the tubercle cent the rate be more slow-moving and interrupted to the medicine and everyday to the medicine same is valid.The anti- fungi medicine fluorine Tong Kang Shi takes orally to absorb completely, the single time take orally or vein to medicine 100 mgs after, average high peak blood medicine density is 4.5 mgs/L~8 mgs/L, cancellation T1/T2 is 27 hs~37 hs, so, using a medicine at a time can immediately acquire a clinical effect.In fine, the PAE research has already more and more been valued in recent years, the PAE reflected the antibiotics still can make the germ be subjected to after remove certain time of repress, the PAE parameter provides more medicine, germ and machine body of threes function relation of information.Combine a medicine to move to learn parameter to make sure to measure to the medicine according to the length in PAE time, partition time with make the antibiotic application be getting more reasonable to the medicine number of times, can reduce to the medicine number of times and raise curative effect and lower bad reaction, reduce a germ to bear medicine deluge and lighten the sufferer’s economic burden.Therefore, the PAE can be reasonable for clinical design of give the medicine project provide science basis, guide clinical more reasonably use antibiotics
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