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老年人由于潜在性的体液和细胞免疫机能的减退,防御感染的能力降低,且各脏器的解剖、生理的变化,故使用抗生素的机会比青壮年显著增多,抗生素的选择、用量也有所不同。一、药物动力学 1.胃肠道的吸收过去文献对于老年人口服抗生素的吸收,意见不一。近年研究表明,老年人的吸收个体差异较大,口服抗生素很难获得稳定的有效血浓度,因此,重症病例以口服外给药为宜。 2.排泄抗生素一般以肝或/及肾为主要代谢-排泄途径,可分为以下三型: (1)主要以活性型从肾脏排泄的抗生素老年人的肾单位随年龄增长而渐减少,因此对以活性型从肾脏排泄的抗生素,如链霉素、庆大霉素、卡那霉素等氨基甙类;粘菌素、多粘菌素等多肽类及先锋霉素Ⅳ等,常易惹致肾脏损害。故一般使用成人常用量
Elderly due to the potential of humoral and cellular immune function decline, reduce the ability to prevent infection, and various organs of the anatomy and physiology changes, so the chances of using antibiotics significantly increased than the young adults, the choice of antibiotics, dosage is also different . First, the pharmacokinetics 1. Gastrointestinal absorption in the past literature for the elderly to take oral antibiotics, different opinions. In recent years, studies have shown that the elderly individual differences in the absorption of large, oral antibiotics is difficult to obtain a stable and effective blood concentration, therefore, severe cases of oral administration is appropriate. 2. Excretion of antibiotics generally liver or / and kidney as the main metabolic - excretion pathway, can be divided into the following three types: (1) mainly by the active type of excretion from the kidneys of the elderly renal nephrons with age and gradually decreased, therefore On the active type of excretion from the kidneys of antibiotics, such as streptomycin, gentamicin, kanamycin and other aminoglycosides; colistin, polymyxin and other peptides and cephalosporins Ⅳ, often easy to provoke Kidney damage. It is generally used by adults commonly used