连续性肾替代治疗抗菌药物剂量调整共识专家组中国药学会医院药学专业委员会中国医药教育协会感染疾病专业委员会
通信作者：卢晓阳，浙江大学医学院附属第一医院临床药学部，杭州310003，Email：luxiaoyang@zju.edu.cn；蔡洪流，浙江大学医学院附属第一医院重症医学科，杭州310003，Email：1193001@zju.edu.cn
推荐意见
1.CRRT不同模式及治疗剂量使药物清除存在差异，抗菌药物剂量调整时应综合考虑患者接受CRRT的模式及治疗剂量。（推荐级别：强推荐）
2.CRRT期间抗菌药物剂量调整应考虑药物特性，如分子量、蛋白结合率、表观分布容积（apparentvolumeofdistribution，Vd）和药物清除途径。（推荐级别：强推荐）
3.对于接受CRRT的重症感染患者，应考虑器官功能状态并结合病原菌最低抑菌浓度（minimuminhibitoryconcentration，MIC）调整抗菌药物剂量，考虑到重症患者PK/PD存在个体差异，血药浓度监测是最佳的抗菌药物剂量调整手段。（推荐级别：强推荐）
8.CRRT不同模式下使用β-内酰胺酶抑制剂复方制剂可参考肾功能正常患者的剂量给药。（推荐级别：弱推荐）
9.CVVHDF治疗剂量为3.0～3.5L/h时，建议给予哌拉西林-他唑巴坦4.5gq8h；CVVH治疗剂量为20～40ml·kg-1·h-1时，建议给予哌拉西林-他唑巴坦3.375gq6h；对于MIC=32mg/L的病原菌感染，建议给予哌拉西林-他唑巴坦4.5gq6h，必要时持续输注或延长输注4h。（推荐级别：强推荐）
10.在重症感染或病原菌MIC较高时，CVVH期间建议头孢哌酮-舒巴坦根据舒巴坦剂量计算，给予舒巴坦≥1gq8h，必要时持续输注或延长输注。（推荐级别：弱推荐）
2.氨基糖苷类抗菌药物：
3.喹诺酮类抗菌药物：
15.主要经肾脏清除的喹诺酮类药物在CRRT期间清除率有所增加，因此需要相应增加剂量。（推荐级别：弱推荐）
16.重症感染时，环丙沙星在CVVH或CVVHDF模式下建议400mgq8h，CVVHD模式下建议200mgq8h。（推荐级别：弱推荐）
17.对于敏感的革兰阳性菌感染，在CVVH或CVVHD模式下，CRRT治疗剂量为25ml·kg-1·h-1或30ml·kg-1·h-1时，建议给予左氧氟沙星500～750mgqd。（推荐级别：弱推荐）
18.莫西沙星经肝肾双通道途径清除，在CRRT期间无需调整剂量。（推荐级别：强推荐）
4.糖肽类抗菌药物：
19.与肾功能正常患者剂量相比，万古霉素和替考拉宁在CRRT期间建议减少给药剂量。（推荐级别：强推荐）
20.在CVVH模式下，建议万古霉素给予负荷剂量20mg/kg，维持剂量500mgq8h；在CVVHDF模式下，建议万古霉素给予负荷剂量20mg/kg，维持剂量500mgq12h。根据血药浓度监测结果调整剂量，维持稳态Cmin在10～20mg/L，或AUC0～24h/MIC在400～600。（推荐级别：强推荐）
21.CRRT时建议替考拉宁给予负荷剂量10～12mg/kgq12h（连续2d），第3天起给予10～12mg/kgq72h。对于非复杂抗甲氧西林金黄色葡萄球菌感染，推荐目标Cmin为15～30mg/L；对于严重和/或复杂性抗甲氧西林金黄色葡萄球菌感染（如心内膜炎、骨髓炎），推荐目标Cmin为20～40mg/L。推荐根据血药浓度监测结果调整剂量。（推荐级别：强推荐）
5.环脂肽类抗菌药物：
22.在CRRT治疗剂量≤25ml·kg-1·h-1时，建议达托霉素给药剂量为6～8mg/kgqd，而在治疗剂量30～35ml·kg-1·h-1下，建议给药剂量为8～10mg/kgqd。（推荐级别：强推荐）
6.噁唑烷酮类抗菌药物：
7.替加环素：
8.多黏菌素类抗菌药物：
9.磺胺类抗菌药物：
1.唑类抗真菌药物:
2.棘白菌素类抗真菌药物：
3.多烯类抗真菌药物：
2.DeepaC,MuralidharK.RenalreplacementtherapyinICU[J].JAnaesthesiolClinPharmacol,2012,28(3):386-396.DOI:10.4103/0970-9185.98357.
3.BellomoR,KellumJA,RoncoC,etal.Acutekidneyinjuryinsepsis[J].IntensiveCareMed,2017,43(6):816-828.DOI:10.1007/s00134-017-4755-7.
4.UchinoS,KellumJA,BellomoR,etal.Acuterenalfailureincriticallyillpatients:amultinational,multicenterstudy[J].JAMA,2005,294(7):813-818.DOI:10.1001/jama.294.7.813.
5.RobertsJA,JoyntGM,LeeA,etal.Theeffectofrenalreplacementtherapyandantibioticdoseonantibioticconcentrationsincriticallyillpatients:datafromthemultinationalsamplingantibioticsinrenalreplacementtherapystudy[J].ClinInfectDis,2021,72(8):1369-1378.DOI:10.1093/cid/ciaa224.
6.KanjiS,RogerC,TacconeFS,etal.Practicalconsiderationsforindividualizingdrugdosingincriticallyilladultsreceivingrenalreplacementtherapy[J].Pharmacotherapy,2023,43(11):1194-1205.DOI:10.1002/phar.2858.
7.HoffBM,MakerJH,DagerWE,etal.Antibioticdosingforcriticallyilladultpatientsreceivingintermittenthemodialysis,prolongedintermittentrenalreplacementtherapy,andcontinuousrenalreplacementtherapy:anupdate[J].AnnPharmacother,2020,54(1):43-55.DOI:10.1177/1060028019865873.
8.WongWT,ChoiG,GomersallCD,etal.Toincreaseordecreasedosageofantimicrobialsinsepticpatientsduringcontinuousrenalreplacementtherapy:theeternaldoubt[J].CurrOpinPharmacol,2015,24:68-78.DOI:10.1016/j.coph.2015.07.003.
9.CoronaA,VeroneseA,SantiniS,etal.'CATCH'study:correctantibiotictherapyincontinuoushemofiltrationinthecriticallyillincontinuousrenalreplacementtherapy:aprospectiveobservationalstudy[J].Antibiotics(Basel),2022,11(12):1811.DOI:10.3390/antibiotics11121811.
10.OnichimowskiD,ZiókowskiH,NosekK,etal.Comparisonofadsorptionofselectedantibioticsonthefiltersincontinuousrenalreplacementtherapycircuits:invitrostudies[J].JArtifOrgans,2020,23(2):163-170.DOI:10.1007/s10047-019-01139-x.
11.UlldemolinsM,Martín-LoechesI,Llauradó-SerraM,etal.Piperacillinpopulationpharmacokineticsincriticallyillpatientswithmultipleorgandysfunctionsyndromereceivingcontinuousvenovenoushaemodiafiltration:effectoftypeofdialysismembraneondosingrequirements[J].JAntimicrobChemother,2016,71(6):1651-1659.DOI:10.1093/jac/dkv503.
12.TandukarS,PalevskyPM.Continuousrenalreplacementtherapy:who,when,why,andhow[J].Chest,2019,155(3):626-638.DOI:10.1016/j.chest.2018.09.004.
13.StevensPE,LevinA,KidneyDisease:ImprovingGlobalOutcomesChronicKidneyDiseaseGuidelineDevelopmentWorkGroupMembers.Evaluationandmanagementofchronickidneydisease:synopsisofthekidneydisease:improvingglobaloutcomes2012clinicalpracticeguideline[J].AnnInternMed,2013,158(11):825-830.DOI:10.7326/0003-4819-158-11-201306040-00007.
14.TulliG.Antibioticdosingduringcontinuousrenalreplacementtherapy(CRRT)[M].//DavideChiumello.Topicalissuesinanesthesiaandintensivecare.Milano,Italy:SpringerInternationalPublishing,2016:1-33.
15.Abdul-AzizMH,AlffenaarJC,BassettiM,etal.Antimicrobialtherapeuticdrugmonitoringincriticallyilladultpatients:apositionpaper[J].IntensiveCareMed,2020,46(6):1127-1153.DOI:10.1007/s00134-020-06050-1.
16.TsujiBT,PogueJM,ZavasckiAP,etal.Internationalconsensusguidelinesfortheoptimaluseofthepolymyxins:endorsedbytheAmericanCollegeofClinicalPharmacy(ACCP),EuropeanSocietyofClinicalMicrobiologyandInfectiousDiseases(ESCMID),InfectiousDiseasesSocietyofAmerica(IDSA),InternationalSocietyforAnti-infectivePharmacology(ISAP),SocietyofCriticalCareMedicine(SCCM),andSocietyofInfectiousDiseasesPharmacists(SIDP)[J].Pharmacotherapy,2019,39(1):10-39.DOI:10.1002/phar.2209.
17.LinB,HuY,XuP,etal.Expertconsensusstatementontherapeuticdrugmonitoringandindividualizationoflinezolid[J].FrontPublicHealth,2022,10:967311.DOI:10.3389/fpubh.2022.967311.
18.ChenK,ZhangX,KeX,etal.IndividualizedMedicationofvoriconazole:apracticeguidelineofthedivisionoftherapeuticdrugmonitoring,Chinesepharmacologicalsociety[J].TherDrugMonit,2018,40(6):663-674.DOI:10.1097/FTD.0000000000000561.
19.DekkersB,BakkerM,vanderElstK,etal.Therapeuticdrugmonitoringofposaconazole:anupdate[J].CurrFungalInfectRep,2016,10:51-61.DOI:10.1007/s12281-016-0255-4.
20.StevensonJM,PatelJH,ChurchwellMD,etal.Ertapenemclearanceduringmodeledcontinuousrenalreplacementtherapy[J].IntJArtifOrgans,2008,31(12):1027-1034.DOI:10.1177/039139880803101206.
21.PistolesiV,MorabitoS,DiMarioF,etal.Aguidetounderstandingantimicrobialdrugdosingincriticallyillpatientsonrenalreplacementtherapy[J].AntimicrobAgentsChemother,2019,63(8):e00583-19.DOI:10.1128/AAC.00583-19.
22.RobertsJA,Abdul-AzizMH,LipmanJ,etal.Individualisedantibioticdosingforpatientswhoarecriticallyill:challengesandpotentialsolutions[J].LancetInfectDis,2014,14(6):498-509.DOI:10.1016/S1473-3099(14)70036-2.
23.CoronaA,CattaneoD,LatronicoN.Antibiotictherapyinthecriticallyillwithacuterenalfailureandrenalreplacementtherapy:anarrativereview[J].Antibiotics(Basel),2022,11(12):1769.DOI:10.3390/antibiotics11121769.
24.TrotmanRL,WilliamsonJC,ShoemakerDM,etal.Antibioticdosingincriticallyilladultpatientsreceivingcontinuousrenalreplacementtherapy[J].ClinInfectDis,2005,41(8):1159-1166.DOI:10.1086/444500.
25.HeintzBH,MatzkeGR,DagerWE.Antimicrobialdosingconceptsandrecommendationsforcriticallyilladultpatientsreceivingcontinuousrenalreplacementtherapyorintermittenthemodialysis[J].Pharmacotherapy,2009,29(5):562-577.DOI:10.1592/phco.29.5.562.
26.CarlierM,TacconeFS,BeumierM,etal.Populationpharmacokineticsanddosingsimulationsofcefepimeinsepticshockpatientsreceivingcontinuousrenalreplacementtherapy[J].IntJAntimicrobAgents,2015,46(4):413-419.DOI:10.1016/j.ijantimicag.2015.05.020.
27.SemberAM,LoFasoME,LewisSJ.Authorresponse:'anoptimalextended-infusiondosingofcefepimeandceftazidimeincriticallyillpatientswithcontinuousrenalreplacementtherapy'[J].JCritCare,2022,70:154059.DOI:10.1016/j.jcrc.2022.154059.
28.JangSM,LewisSJ,RhieSJ.Optimalantipseudomonal-lactamdrugdosingrecommendationsincritically-illAsianpatientsreceivingCRRT[J].JCritCare,2022,72:154172.DOI:10.1016/j.jcrc.2022.154172.
29.ChaijamornW,CharoensareeratT,SrisawatN,etal.Cefepimedosingregimensincriticallyillpatientsreceivingcontinuousrenalreplacementtherapy:aMonteCarlosimulationstudy[J].JIntensiveCare,2018,6:61.DOI:10.1186/s40560-018-0330-8.
30.MariatC,VenetC,JehlF,etal.Continuousinfusionofceftazidimeincriticallyillpatientsundergoingcontinuousvenovenoushaemodiafiltration:pharmacokineticevaluationanddoserecommendation[J].CritCare,2006,10(1):R26.DOI:10.1186/cc3993.
31.PhilpottCD,DroegeCA,DroegeME,etal.Pharmacokineticsandpharmacodynamicsofextended-infusioncefepimeincriticallyillpatientsreceivingcontinuousrenalreplacementtherapy:aprospective,open-labelstudy[J].Pharmacotherapy,2019,39(11):1066-1076.DOI:10.1002/phar.2332.
32.Al-ShaerMH,PhilpottCD,DroegeCA,etal.Cefepimepopulationpharmacokineticsandtargetattainmentincriticallyillpatientsoncontinuousrenalreplacementtherapy[J].AntimicrobAgentsChemother,2021,65(6):e00144-21.DOI:10.1128/AAC.00144-21.
33.GotoK,SatoY,YasudaN,etal.Pharmacokineticsofceftriaxoneinpatientsundergoingcontinuousrenalreplacementtherapy[J].JBasicClinPhysiolPharmacol,2016,27(6):625-631.DOI:10.1515/jbcpp-2016-0022.
34.RogerC,CottaMO,MullerL,etal.Impactofrenalreplacementmodalitiesontheclearanceofpiperacillin-tazobactamadministeredviacontinuousinfusionincriticallyillpatients[J].IntJAntimicrobAgents,2017,50(2):227-231.DOI:10.1016/j.ijantimicag.2017.03.018.
35.SeylerL,CottonF,TacconeFS,etal.Recommendedβ-lactamregimensareinadequateinsepticpatientstreatedwithcontinuousrenalreplacementtherapy[J].CritCare,2011,15(3):R137.DOI:10.1186/cc10257.
36.VargheseJM,JarrettP,BootsRJ,etal.Pharmacokineticsofpiperacillinandtazobactaminplasmaandsubcutaneousinterstitialfluidincriticallyillpatientsreceivingcontinuousvenovenoushaemodiafiltration[J].IntJAntimicrobAgents,2014,43(4):343-348.DOI:10.1016/j.ijantimicag.2014.01.009.
37.Asín-PrietoE,Rodríguez-GascónA,TrocónizIF,etal.Populationpharmacokineticsofpiperacillinandtazobactamincriticallyillpatientsundergoingcontinuousrenalreplacementtherapy:applicationtopharmacokinetic/pharmacodynamicanalysis[J].JAntimicrobChemother,2014,69(1):180-189.DOI:10.1093/jac/dkt304.
38.JamalJA,RobertsDM,UdyAA,etal.Pharmacokineticsofpiperacillinincriticallyillpatientsreceivingcontinuousvenovenoushaemofiltration:arandomisedcontrolledtrialofcontinuousinfusionversusintermittentbolusadministration[J].IntJAntimicrobAgents,2015,46(1):39-44.DOI:10.1016/j.ijantimicag.2015.02.014.
39.ShotwellMS,NesbittR,MadoniaPN,etal.Pharmacokineticsandpharmacodynamicsofextendedinfusionversusshortinfusionpiperacillin-tazobactamincriticallyillpatientsundergoingCRRT[J].ClinJAmSocNephrol,2016,11(8):1377-1383.DOI:10.2215/CJN.10260915.
40.RichterDC,FreyO,RhrA,etal.Therapeuticdrugmonitoring-guidedcontinuousinfusionofpiperacillin/tazobactamsignificantlyimprovespharmacokinetictargetattainmentincriticallyillpatients:aretrospectiveanalysisoffouryearsofclinicalexperience[J].Infection,2019,47(6):1001-1011.DOI:10.1007/s15010-019-01352-z.
41.AwissiDK,BeauchampA,HébertE,etal.Pharmacokineticsofanextended4-hourinfusionofpiperacillin-tazobactamincriticallyillpatientsundergoingcontinuousrenalreplacementtherapy[J].Pharmacotherapy,2015,35(6):600-607.DOI:10.1002/phar.1604.
42.GaoC,TongJ,YuK,etal.Pharmacokineticsofcefoperazone/sulbactamincriticallyillpatientsreceivingcontinuousvenovenoushemofiltration[J].EurJClinPharmacol,2016,72(7):823-830.DOI:10.1007/s00228-016-2045-x.
43.WenzlerE,BunnellKL,BleasdaleSC,etal.Pharmacokineticsanddialyticclearanceofceftazidime-avibactaminacriticallyillpatientoncontinuousvenovenoushemofiltration[J].AntimicrobAgentsChemother,2017,61(7):e00464-17.DOI:10.1128/AAC.00464-17.
44.SoukupP,FaustAC,EdpugantiV,etal.Steady-stateceftazidime-avibactamserumconcentrationsanddosingrecommendationsinacriticallyillpatientbeingtreatedforpseudomonasaeruginosapneumoniaandundergoingcontinuousvenovenoushemodiafiltration[J].Pharmacotherapy,2019,39(12):1216-1222.DOI:10.1002/phar.2338.
45.ZhangXS,WangYZ,ShiDW,etal.Correctionto:efficacyandpharmacodynamictargetattainmentforceftazidime-avibactamoff-labeldoseregimensinpatientswithcontinuousorintermittentvenovenoushemodialysis:twocasereports[J].InfectDisTher,2022,11(6):2321.DOI:10.1007/s40121-022-00675-z.
46.GattiM,RinaldiM,GaibaniP,etal.Adescriptivepharmacokinetic/pharmacodynamicanalysisofcontinuousinfusionceftazidime-avibactamfortreatingDTRgram-negativeinfectionsinacaseseriesofcriticallyillpatientsundergoingcontinuousveno-venoushaemodiafiltration(CVVHDF)[J].JCritCare,2023,76:154301.DOI:10.1016/j.jcrc.2023.154301.
47.CottonA,FranklinBD,BrettS,etal.Usingimipenemandcilastatinduringcontinuousrenalreplacementtherapy[J].PharmWorldSci,2005,27(5):371-375.DOI:10.1007/s11096-005-1636-x.
48.BoucherBA,HudsonJQ,HillDM,etal.Pharmacokineticsofimipenem/cilastatinburnintensivecareunitpatientsundergoinghigh-dosecontinuousvenovenoushemofiltration[J].Pharmacotherapy,2016,36(12):1229-1237.DOI:10.1002/phar.1866.
49.LiZ,BaiJ,WenA,etal.Pharmacokineticandpharmacodynamicanalysisofcriticallyillpatientsundergoingcontinuousrenalreplacementtherapywithimipenem[J].ClinTher,2020,42(8):1564-1577.e8.DOI:10.1016/j.clinthera.2020.06.010.
50.LiS,XieF.Populationpharmacokineticsandsimulationsofimipenemincriticallyillpatientsundergoingcontinuousrenalreplacementtherapy[J].IntJAntimicrobAgents,2019,53(1):98-105.DOI:10.1016/j.ijantimicag.2018.10.006.
51.FishDN,TeitelbaumI,AbrahamE.Pharmacokineticsandpharmacodynamicsofimipenemduringcontinuousrenalreplacementtherapyincriticallyillpatients[J].AntimicrobAgentsChemother,2005,49(6):2421-2428.DOI:10.1128/AAC.49.6.2421-2428.2005.
52.KawanoS,MatsumotoK,HaraR,etal.PharmacokineticsanddosingestimationofmeropeneminJapanesepatientsreceivingcontinuousvenovenoushemodialysis[J].JInfectChemother,2015,21(6):476-478.DOI:10.1016/j.jiac.2015.02.011.
53.GrensemannJ,BusseD,KnigC,etal.Acute-on-chronicliverfailurealtersmeropenempharmacokineticsincriticallyillpatientswithcontinuoushemodialysis:anobservationalstudy[J].AnnIntensiveCare,2020,10(1):48.DOI:10.1186/s13613-020-00666-8.
54.CharoensareeratT,ChaijamornW,KerdnimithP,etal.Optimalmeropenemdosingregimensinpatientsundergoingcontinuousrenalreplacementtherapy:systematicreviewandMonteCarlosimulations[J].BloodPurif,2023,52(6):503-515.DOI:10.1159/000529694.
55.ChaijamornW,RungkitwattanakulD,PattharachayakulS,etal.Meropenemdosingrecommendationsforcriticallyillpatientsreceivingcontinuousrenalreplacementtherapy[J].JCritCare,2020,60:285-289.DOI:10.1016/j.jcrc.2020.09.001.
56.LanggartnerJ,VasoldA,GlückT,etal.Pharmacokineticsofmeropenemduringintermittentandcontinuousintravenousapplicationinpatientstreatedbycontinuousrenalreplacementtherapy[J].IntensiveCareMed,2008,34(6):1091-1096.DOI:10.1007/s00134-008-1034-7.
57.BurgerR,GuidiM,CalpiniV,etal.Effectofrenalclearanceandcontinuousrenalreplacementtherapyonappropriatenessofrecommendedmeropenemdosingregimensincriticallyillpatientswithsusceptiblelife-threateninginfections[J].JAntimicrobChemother,2018,73(12):3413-3422.DOI:10.1093/jac/dky370.
58.Nowak-KózkaI,PolokKJ,GórkaJ,etal.Concentrationofmeropeneminpatientswithsepsisandacutekidneyinjurybeforeandafterinitiationofcontinuousrenalreplacementtherapy:aprospectiveobservationaltrial[J].PharmacolRep,2020,72(1):147-155.DOI:10.1007/s43440-019-00056-3.
59.GattiM,RinaldiM,TonettiT,etal.Real-timeTDM-basedexpertclinicalpharmacologicaladviceprogramforattainingaggressivepharmacokinetic/pharmacodynamictargetofcontinuousinfusionmeropeneminthetreatmentofcriticallyillpatientswithdocumentedgram-negativeinfectionsundergoingcontinuousveno-venoushemodiafiltration[J].Antibiotics(Basel),2023,12(10):1524.DOI:10.3390/antibiotics12101524.
60.PengY,ChengZ,XieF.Populationpharmacokineticmeta-analysisanddosingrecommendationformeropenemincriticallyillpatientsreceivingcontinuousrenalreplacementtherapy[J].AntimicrobAgentsChemother,2022,66(9):e0082222.DOI:10.1128/aac.00822-22.
61.TacconeFS,deBackerD,LaterrePF,etal.Pharmacokineticsofaloadingdoseofamikacininsepticpatientsundergoingcontinuousrenalreplacementtherapy[J].IntJAntimicrobAgents,2011,37(6):531-535.DOI:10.1016/j.ijantimicag.2011.01.026.
62.LiS,ZhuS,XieF.Populationpharmacokinetic/pharmacodynamicevaluationsofamikacindosingincriticallyillpatientsundergoingcontinuousvenovenoushemodiafiltration[J].JPharmPharmacol,2023,75(4):515-522.DOI:10.1093/jpp/rgad005.
63.RogerC,WallisSC,MullerL,etal.Influenceofrenalreplacementmodalitiesonamikacinpopulationpharmacokineticsincriticallyillpatientsoncontinuousrenalreplacementtherapy[J].AntimicrobAgentsChemother,2016,60(8):4901-4909.DOI:10.1128/AAC.00828-16.
64.LamSW,BauerSR.Amikacinpharmacokineticsduringcontinuousveno-venoushemodialysis[J].InfectDisTher,2013,2(2):217-226.DOI:10.1007/s40121-013-0012-8.
65.RogerC,WallisSC,LouartB,etal.Comparisonofequaldosesofcontinuousvenovenoushaemofiltrationandhaemodiafiltrationonciprofloxacinpopulationpharmacokineticsincriticallyillpatients[J].JAntimicrobChemother,2016,71(6):1643-1650.DOI:10.1093/jac/dkw043.
66.RoehrAC,FreyOR,KoebererA,etal.Anti-infectivedrugsduringcontinuoushemodialysis-usingthebenchtolearnwhattodoatthebedside[J].IntJArtifOrgans,2015,38(1):17-22.DOI:10.5301/ijao.5000377.
67.WallisSC,MullanyDV,LipmanJ,etal.PharmacokineticsofciprofloxacininICUpatientsoncontinuousveno-venoushaemodiafiltration[J].IntensiveCareMed,2001,27(4):665-672.DOI:10.1007/s001340100857.
68.SpoonerAM,DeeganC,D'ArcyDM,etal.Anevaluationofciprofloxacinpharmacokineticsincriticallyillpatientsundergoingcontinuousveno-venoushaemodiafiltration[J].BMCClinPharmacol,2011,11:11.DOI:10.1186/1472-6904-11-11.
69.OnichimowskiD,WolskaJ,ZiókowskiH,etal.Pharmacokineticsofciprofloxacinduringcontinuousrenalreplacementtherapyinintensivecarepatients-newassessment[J].AnaesthesiolIntensiveTher,2020,52(4):267-273.DOI:10.5114/ait.2020.99605.
70.MaloneRS,FishDN,AbrahamE,etal.Pharmacokineticsoflevofloxacinandciprofloxacinduringcontinuousrenalreplacementtherapyincriticallyillpatients[J].AntimicrobAgentsChemother,2001,45(10):2949-2954.DOI:10.1128/AAC.45.10.2949-2954.2001.
71.ShawAR,MuellerBA.Antibioticdosingincontinuousrenalreplacementtherapy[J].AdvChronicKidneyDis,2017,24(4):219-227.DOI:10.1053/j.ackd.2017.05.004.
72.TokimatsuI,ShigemuraK,KotakiT,etal.Aprospectivestudyoftheefficacy,safetyandpharmacokineticsofenteralmoxifloxacininthetreatmentofhemodialysispatientswithpneumonia[J].InternMed,2017,56(11):1315-1319.DOI:10.2169/internalmedicine.56.8369.
73.FuhrmannV,SchenkP,JaegerW,etal.Pharmacokineticsofmoxifloxacininpatientsundergoingcontinuousvenovenoushaemodiafiltration[J].JAntimicrobChemother,2004,54(4):780-784.DOI:10.1093/jac/dkh421.
74.OmraniAS,MouslyA,CabalunaMP,etal.Vancomycintherapyincriticallyillpatientsoncontinuousrenalreplacementtherapy;arewedoingenough[J].SaudiPharmJ,2015,23(3):327-329.DOI:10.1016/j.jsps.2014.08.005.
75.ChaijamornW,JitsurongA,WiwattanawongsaK,etal.Vancomycinclearanceduringcontinuousvenovenoushaemofiltrationincriticallyillpatients[J].IntJAntimicrobAgents,2011,38(2):152-156.DOI:10.1016/j.ijantimicag.2011.04.010.
76.LiQ,LiangF,SangL,etal.Pharmacokineticsofandmaintenancedoserecommendationsforvancomycininseverepneumoniapatientsundergoingcontinuousvenovenoushemofiltrationwiththecombinationofpredilutionandpostdilution[J].EurJClinPharmacol,2020,76(2):211-217.DOI:10.1007/s00228-019-02755-5.
77.WahbyKA,CunmuljajL,MouabbiK,etal.Evaluationofdosingstrategiesandtroughconcentrationsofvancomycininpatientsundergoingcontinuousvenovenoushemofiltration[J].Pharmacotherapy,2021,41(7):554-561.DOI:10.1002/phar.2535.
78.QuinnNJ,SachaGL,WanekMR,etal.Determinantsofvancomycintroughconcentrationinpatientsreceivingcontinuousveno-venoushemodialysis[J].AnnPharmacother,2022,56(10):1133-1138.DOI:10.1177/10600280211073370.
79.MatsumotoK,TakesueY,OhmagariN,etal.Practiceguidelinesfortherapeuticdrugmonitoringofvancomycin:aconsensusreviewoftheJapanesesocietyofchemotherapyandtheJapanesesocietyoftherapeuticdrugmonitoring[J].JInfectChemother,2013,19(3):365-380.DOI:10.1007/s10156-013-0599-4.
80.KirwanM,MunshiR,O'KeeffeH,etal.Exploringpopulationpharmacokineticmodelsinpatientstreatedwithvancomycinduringcontinuousvenovenoushaemodiafiltration(CVVHDF)[J].CritCare,2021,25(1):443.DOI:10.1186/s13054-021-03863-4.
81.CharoensareeratT,ChaijamornW,BoonpengA,etal.Optimalvancomycindosingregimensforcriticallyillpatientswithacutekidneyinjuryduringcontinuousrenalreplacementtherapy:aMonteCarlosimulationstudy[J].JCritCare,2019,54:77-82.DOI:10.1016/j.jcrc.2019.07.008.
82.RybakMJ,LeJ,LodiseT,etal.Executivesummary:therapeuticmonitoringofvancomycinforseriousmethicillin-resistantstaphylococcusaureusinfections:arevisedconsensusguidelineandreviewoftheamericansocietyofhealth-systempharmacists,theinfectiousdiseasessocietyofamerica,thepediatricinfectiousdiseasessociety,andthesocietyofinfectiousdiseasespharmacists[J].JPediatricInfectDisSoc,2020,9(3):281-284.DOI:10.1093/jpids/piaa057.
83.ChenJ,LiS,WangQ,etal.OptimizingantimicrobialdosingforcriticallyillpatientswithMRSAinfections:anewparadigmforimprovingefficacyduringcontinuousrenalreplacementtherapy[J].Pharmaceutics,2022,14(4):842.DOI:10.3390/pharmaceutics14040842.
84.WangC,ChenJ,YangB,etal.Determinationofvancomycinexposuretargetandindividualizeddosingrecommendationsforcriticallyillpatientsundergoingcontinuousrenalreplacementtherapy[J].Pharmacotherapy,2023,43(3):180-188.DOI:10.1002/phar.2771.
85.ThalhammerF,RosenkranzAR,BurgmannH,etal.Single-dosepharmacokineticsofteicoplaninduringhemodialysistherapyusinghigh-fluxpolysulfonemembranes[J].WienKlinWochenschr,1997,109(10):362-365.
86.ShiraishiY,OkajimaM,SaiY,etal.Eliminationofteicoplaninbyadsorptiontothefiltermembraneduringhaemodiafiltration:screeningexperimentsforlinezolid,teicoplaninandvancomycinfollowedbyinvitrohaemodiafiltrationmodelsforteicoplanin[J].AnaesthIntensiveCare,2012,40(3):442-449.DOI:10.1177/0310057X1204000309.
87.BellmannR,FalkensammerG,SegerC,etal.Teicoplaninpharmacokineticsincriticallyillpatientsoncontinuousveno-venoushemofiltration[J].IntJClinPharmacolTher,2010,48(4):243-249.
88.WolterK,ClausM,FritschkaE.Pharmacokineticsanddosagerecommendationsofteicoplanininpatientstreatedbycontinuousveno-venoushaemodialysis(CVVHD)[J].EurJClinPharmacol,1994,46(2):179-180.DOI:10.1007/BF00199886.
89.UedaT,TakesueY,NakajimaK,etal.Enhancedloadingdoseofteicoplaninforthreedaysisrequiredtoachieveatargettroughconcentrationof20μg/mlinpatientsreceivingcontinuousvenovenoushaemodiafiltrationwithalowflowrate[J].JInfectChemother,2022,28(2):232-237.DOI:10.1016/j.jiac.2021.10.023.
90.BastienO,BoulieuR,BleyzacN,etal.Clinicaluseofganciclovirduringrenalfailureandcontinuoushemodialysis[J].IntensiveCareMed,1994,20(1):47-48.DOI:10.1007/BF02425056.
91.HanaiY,TakahashiY,NiwaT,etal.Clinicalpracticeguidelinesfortherapeuticdrugmonitoringofteicoplanin:aconsensusreviewbytheJapanesesocietyofchemotherapyandtheJapanesesocietyoftherapeuticdrugmonitoring[J].JAntimicrobChemother,2022,77(4):869-879.DOI:10.1093/jac/dkab499.
92.PreiswerkB,RudigerA,FehrJ,etal.ExperiencewithdaptomycindailydosinginICUpatientsundergoingcontinuousrenalreplacementtherapy[J].Infection,2013,41(2):553-557.DOI:10.1007/s15010-012-0300-3.
93.CortiN,RudigerA,ChiesaA,etal.Pharmacokineticsofdailydaptomycinincriticallyillpatientsundergoingcontinuousrenalreplacementtherapy[J].Chemotherapy,2013,59(2):143-151.DOI:10.1159/000353400.
94.XuX,KhadzhynovD,PetersH,etal.Populationpharmacokineticsofdaptomycininadultpatientsundergoingcontinuousrenalreplacementtherapy[J].BrJClinPharmacol,2017,83(3):498-509.DOI:10.1111/bcp.13131.
95.XieF,LiS,ChengZ.Populationpharmacokineticsanddosingconsiderationsofdaptomycinincriticallyillpatientsundergoingcontinuousrenalreplacementtherapy[J].JAntimicrobChemother,2020,75(6):1559-1566.DOI:10.1093/jac/dkaa028.
96.VillaG,DiMaggioP,DeGaudioAR,etal.Effectsofcontinuousrenalreplacementtherapyonlinezolidpharmacokinetic/pharmacodynamics:asystematicreview[J].CritCare,2016,20(1):374.DOI:10.1186/s13054-016-1551-7.
97.BarrasaH,SoraluceA,IslaA,etal.Pharmacokineticsoflinezolidincriticallyillpatientsoncontinuousrenalreplacementtherapy:influenceofresidualrenalfunctiononPK/PDtargetattainment[J].JCritCare,2019,50:69-76.DOI:10.1016/j.jcrc.2018.11.016.
98.IdeT,TakesueY,IkawaK,etal.Populationpharmacokinetics/pharmacodynamicsoflinezolidinsepsispatientswithandwithoutcontinuousrenalreplacementtherapy[J].IntJAntimicrobAgents,2018,51(5):745-751.DOI:10.1016/j.ijantimicag.2018.01.021.
99.BroekerA,WichaSG,DornC,etal.Tigecyclineincriticallyillpatientsoncontinuousrenalreplacementtherapy:apopulationpharmacokineticstudy[J].CritCare,2018,22(1):341.DOI:10.1186/s13054-018-2278-4.
100.ZhaoHH,TangWJ,YangYX,etal.PK/PDstudyoftigecyclineinseverelyinfectedpatientswithcontinuousrenalreplacementtherapy[J].IntJClinPharmacolTher,2020,58(10):531-538.DOI:10.5414/CP203669.
101.HuangF,CaoWX,YanYY,etal.Influenceofcontinuousrenalreplacementtherapyontheplasmaconcentrationoftigecyclineinpatientswithsepticshock:aprospectiveobservationalstudy[J].FrontPharmacol,2023,14:1118788.DOI:10.3389/fphar.2023.1118788.
102.MarkouN,FousteriM,MarkantonisSL,etal.Colistinpharmacokineticsinintensivecareunitpatientsoncontinuousvenovenoushaemodiafiltration:anobservationalstudy[J].JAntimicrobChemother,2012,67(10):2459-2462.DOI:10.1093/jac/dks257.
103.LiJ,RaynerCR,NationRL,etal.Pharmacokineticsofcolistinmethanesulfonateandcolistininacriticallyillpatientreceivingcontinuousvenovenoushemodiafiltration[J].AntimicrobAgentsChemother,2005,49(11):4814-4815.DOI:10.1128/AAC.49.11.4814-4815.2005.
104.KaraiskosI,FribergLE,GalaniL,etal.Challengeforhighercolistindosageincriticallyillpatientsreceivingcontinuousvenovenoushaemodiafiltration[J].IntJAntimicrobAgents,2016,48(3):337-341.DOI:10.1016/j.ijantimicag.2016.06.008.
105.SpapenH,vanLaethemJ,HitesM,etal.Treatmentofventilator-associatedpneumoniawithhigh-dosecolistinundercontinuousveno-venoushemofiltration[J].JTranslIntMed,2019,7(3):100-105.DOI:10.2478/jtim-2019-0022.
106.SandriAM,LandersdorferCB,JacobJ,etal.PharmacokineticsofpolymyxinBinpatientsoncontinuousvenovenoushaemodialysis[J].JAntimicrobChemother,2013,68(3):674-677.DOI:10.1093/jac/dks437.
107.WangP,XingH,ZhangF,etal.PopulationpharmacokineticsofpolymyxinBincriticallyillpatientsreceivingcontinuousvenovenoushaemofiltration[J].IntJAntimicrobAgents,2022,60(1):106599.DOI:10.1016/j.ijantimicag.2022.106599.
108.PiMY,CaiCJ,ZuoLY,etal.PopulationpharmacokineticsandlimitedsamplingstrategiesofpolymyxinBincriticallyillpatients[J].JAntimicrobChemother,2023,78(3):792-801.DOI:10.1093/jac/dkad012.
109.HanafinPO,KwaA,ZavasckiAP,etal.ApopulationpharmacokineticmodelofpolymyxinBbasedonprospectiveclinicaldatatoinformdosinginhospitalizedpatients[J].ClinMicrobiolInfect,2023,29(9):1174-1181.DOI:10.1016/j.cmi.2023.05.018.
110.SurovoyYA,BurkinMA,GalvidisIA,etal.ComparativepolymyxinBpharmacokineticsincriticallyillpatientswithrenalinsufficiencyandincontinuousveno-venoushemodialysis[J].EurJClinPharmacol,2023,79(1):79-87.DOI:10.1007/s00228-022-03415-x.
111.CurkovicI,LüthiB,FranzenD,etal.Trimethoprim/sulfamethoxazolepharmacokineticsintwopatientsundergoingcontinuousvenovenoushemodiafiltration[J].AnnPharmacother,2010,44(10):1669-1672.DOI:10.1345/aph.1P160.
112.KesnerJM,Yardman-FrankJM,MercierRC,etal.Trimethoprimandsulfamethoxazoletransmembraneclearanceduringmodeledcontinuousrenalreplacementtherapy[J].BloodPurif,2014,38(3-4):195-202.DOI:10.1159/000368884.
113.OualhaM,TréluyerJM,MoshousD,etal.Fluconazoleexposureinplasmaandbileduringcontinuousvenovenoushemodialysis[J].TherDrugMonit,2019,41(4):544-546.DOI:10.1097/FTD.0000000000000641.
114.LopezND,PhillipsKM.Fluconazolepharmacokineticsinamorbidlyobese,criticallyillpatientreceivingcontinuousvenovenoushemofiltration[J].Pharmacotherapy,2014,34(9):e162-e168.DOI:10.1002/phar.1470.
115.PatelK,RobertsJA,LipmanJ,etal.Populationpharmacokineticsoffluconazoleincriticallyillpatientsreceivingcontinuousvenovenoushemodiafiltration:usingMonteCarlosimulationstopredictdosesforspecifiedpharmacodynamictargets[J].AntimicrobAgentsChemother,2011,55(12):5868-5873.DOI:10.1128/AAC.00424-11.
116.SimeFB,StuartJ,ButlerJ,etal.Apharmacokineticcasestudyofintravenousposaconazoleinacriticallyillpatientwithhypoalbuminaemiareceivingcontinuousvenovenoushaemodiafiltration[J].IntJAntimicrobAgents,2018,52(4):506-509.DOI:10.1016/j.ijantimicag.2018.07.008.
117.KiserTH,FishDN,AquilanteCL,etal.Evaluationofsulfobutylether-β-cyclodextrin(SBECD)accumulationandvoriconazolepharmacokineticsincriticallyillpatientsundergoingcontinuousrenalreplacementtherapy[J].CritCare,2015,19(1):32.DOI:10.1186/s13054-015-0753-8.
118.MorrisAA,MuellerSW,RowerJE,etal.Evaluationofsulfobutylether-β-cyclodextrinexposureinacriticallyillpatientreceivingintravenousposaconazolewhileundergoingcontinuousvenovenoushemofiltration[J].AntimicrobAgentsChemother,2015,59(10):6653-6656.DOI:10.1128/AAC.01493-15.
119.BiagiM,ButlerD,TanX,etal.Pharmacokineticsanddialyticclearanceofisavuconazoleduringinvitroandinvivocontinuousrenalreplacementtherapy[J].AntimicrobAgentsChemother,2019,63(12):e01085-19.DOI:10.1128/AAC.01085-19.
120.VossenMG,KnaflD,HaidingerM,etal.Micafunginplasmalevelsarenotaffectedbycontinuousrenalreplacementtherapy:experienceincriticallyillpatients[J].AntimicrobAgentsChemother,2017,61(8):e02425-16.DOI:10.1128/AAC.02425-16.
121.WeilerS,SegerC,PfistererH,etal.Pharmacokineticsofcaspofunginincriticallyillpatientsoncontinuousrenalreplacementtherapy[J].AntimicrobAgentsChemother,2013,57(8):4053-4057.DOI:10.1128/AAC.00335-13.
122.RogerC,WallisSC,MullerL,etal.Caspofunginpopulationpharmacokineticsincriticallyillpatientsundergoingcontinuousveno-venoushaemofiltrationorhaemodiafiltration[J].ClinPharmacokinet,2017,56(9):1057-1068.DOI:10.1007/s40262-016-0495-z.
123.HonorePM,DeBelsD,AttouR,etal.Adsorptionandcaspofungindosingduringcontinuousrenalreplacementtherapy[J].CritCare,2019,23(1):240.DOI:10.1186/s13054-019-2526-2.
124.GonzálezdeMolinaF,Martínez-AlbericiMdeL,FerrerR.Treatmentwithechinocandinsduringcontinuousrenalreplacementtherapy[J].CritCare,2014,18(2):218.DOI:10.1186/cc13803.
125.BellmannR,EggerP,GritschW,etal.AmphotericinBlipidformulationsincriticallyillpatientsoncontinuousveno-venoushaemofiltration[J].JAntimicrobChemother,2003,51(3):671-681.DOI:10.1093/jac/dkg139.
126.MaloneME,CorriganOI,KavanaghPV,etal.PharmacokineticsofamphotericinBlipidcomplexincriticallyillpatientsundergoingcontinuousvenovenoushaemodiafiltration[J].IntJAntimicrobAgents,2013,42(4):335-342.DOI:10.1016/j.ijantimicag.2013.06.011.
127.ObataY,TakazonoT,TashiroM,etal.Correctionto:theclinicalusageofliposomalamphotericinBinpatientsreceivingrenalreplacementtherapyinJapan:anationwideobservationalstudy[J].ClinExpNephrol,2021,25(3):288.DOI:10.1007/s10157-020-02004-5.
引用本文：连续性肾替代治疗抗菌药物剂量调整共识专家组,中国药学会医院药学专业委员会,中国医药教育协会感染疾病专业委员会.连续性肾替代治疗抗菌药物剂量调整专家共识（2024年版）[J].中华肾脏病杂志,2024,40(2):158-174.DOI:10.3760/cma.j.cn441217-20230906-00906.