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Updated: Jul 23, 2025
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达普托米辛暴露作为达普托米辛诱导的异性肺炎和肌肉毒性的危险因素
Romain Garreau1,2, Truong-Thanh Pham3,4, Laurent Bourguignon1,2,5
1Hospices Civils de Lyon, Groupement Hospitalier Nord, Service de Pharmacie, Lyon, France.
概括
对骨和关节感染的高剂量达普托米辛会增加诸如乙性肺炎和肌肉毒性等不良事件. 监测达普素水平和C-反应蛋白可以优化治疗的安全性和有效性.
科学领域:
- 药理学 药理学是指药理学的学科.
- 传染性疾病 传染性疾病
- 临床毒理学 临床毒理学
背景情况:
- 用于治疗骨关节感染 (BJI) 的高剂量达普素的使用正在增加.
- 这增加了人们对不良事件 (AE) 的担忧,特别是达普素诱导的性肺炎 (DIEP) 和肌肉毒性.
- 确定这些AE的决定因素对于患者的安全至关重要.
研究的目的:
- 调查影响DIEP和BJI患者肌肉毒性的药理动力学和其他因素.
- 在这个人群中分析与达普素相关的副作用相关的风险因素.
主要方法:
- 接受达普托米辛的BJI患者的前性队列研究.
- 病例控制分析匹配DIEP/肌毒性病例 (9/26) 与对照 (106) 在1:3的比例.
- 用治疗药物监测 (TDM) 数据和Cox比例危险建模进行风险因素分析,对达普托米辛AUC24h的贝叶斯估计.
主要成果:
- 达普托米辛AUC24h,C反应蛋白和血清蛋白水平与AE风险有关.
- 高达普托米辛AUC24小时 (>939毫克/小时/升) 增加了AE风险 (HR 3.1).
- 较高的C-反应蛋白 (>21.6 mg/L) 和较低的血清蛋白 (<72 g/L) 也是显著的危险因素.
结论:
- 在BJI患者中确定了DIEP和肌肉毒性的共同决定因素.
- 达普托米辛TDM和基于模型的精确剂量可以提高治疗的有效性和安全性.
- 在BJI中,建议达普托米辛治疗的目标AUC24h范围为666-939 mg/h/L.
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