血液学的疾患を有する患者におけるアミカシンの集団薬理動力学:前向きな観察研究
Sarah Dräger1, Sereina Livia Müller2, Severin Bausch2
1Division of Internal Medicine, University Hospital Basel, Basel, Switzerland; Department of Clinical Research, University of Basel, Basel, Switzerland.
The Journal of infection
|February 20, 2026
まとめ
発熱性ニュートロペニアの血液学的疾患を有する患者のアミカシン投与では,目標値の達成率が低いことが示されました. これらの脆弱な患者におけるアミカシンの有効性を改善するために,投与量の最適化は極めて重要です.
科学分野:
- 薬理学とセラピュティクス
- 血液学 ヘマトロジ
- 感染症 感染症は感染症です.
背景:
- 血液学的疾患を有する患者は,感染症のリスクが高い.
- 発熱性中性子症 (FN) は,これらの患者における一般的で深刻な合併症です.
- アミカシンは,重度の感染症とFNの治療に頻繁に使用されます.
研究 の 目的:
- 血液学的疾患を有する患者におけるアミカシンの目標値の達成度を評価する.
- アミカシンの集団薬動力学 (PK) モデルを開発する.
- アミカシン曝露と有効性に影響を与える要因を特定する.
主な方法:
- 単一のセンターでの見通しの観察研究.
- アミカシンを投与している血液学的疾患を有する成人の患者を含む.
- アミカシンの血中濃度の測定は,投与後1時間および8時間.
- 個人の被曝を推定するための集団PKモデルの開発.
主要な成果:
- 目標値の低値達成 (Cmax ≥60mg/L) は,患者の19.3%で観察されました.
- 特定された病原体を持つ患者の100%で高い目標値 (Cmax/MIC ≥8) を達成した.
- 体重とGFRは,PKモデルにおける有意な予測因子として特定されました.
結論:
- アミカシンの標的値の達成は,血液学的悪性腫瘍の患者で,特にMICの高い病原体で,FNのために実証的に治療された患者で最適以下です.
- 現在の投与戦略は,治療結果を改善するために最適化が必要になる可能性があります.
- 個別化用投与に関するさらなる研究が必要である.
関連する概念動画
Estimation of k and VD of Aminoglycosides
274
Aminoglycosides are a class of antibiotics used to treat various bacterial infections. Clinicians must determine the elimination rate constant (k) and volume of distribution (VD) to optimize therapeutic efficacy and minimize toxicity. The k value represents the rate at which the drug is removed from the body, and the VD reflects the degree to which the drug distributes into body tissues. Accurately estimating these parameters allows healthcare professionals to tailor drug dosing to individual...
274
Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations
286
Gentamicin, an aminoglycoside antibiotic, is commonly administered via intermittent intravenous infusion to treat severe infections. An intermittent one-hour infusion of gentamicin, administered at eight-hour intervals, allows for precise control of plasma drug concentrations, minimizing toxicity while ensuring therapeutic efficacy. Pharmacokinetic principles govern the dynamics of plasma concentrations and can be mathematically described using specific equations.The plasma drug concentration...
286
Pharmacokinetics in Pediatric Patients: Drug Excretion
302
In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
302
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion
274
In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
274
Drug Accumulation During Multiple Dosing: Intermittent IV Infusions
290
Intermittent intravenous (IV) infusion is a method of drug administration where medications are delivered over short infusion periods followed by intervals of no drug delivery. This approach helps to prevent sustained high drug concentrations in the bloodstream, reducing the risk of adverse effects associated with prolonged exposure. Unlike continuous infusion, steady-state concentrations may not be achieved during a single dosing cycle but can be reached through repeated...
290
Pharmacokinetics in Pediatric Patients: Drug Distribution
354
Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight,...
354


