使用贝叶斯预测的剂量软件在达到重症患者目标抗生素暴露的效率,前性队列研究
Ming G Chai1, Jason A Roberts2, Christina F Kelly3
1Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia; Pharmacy Department, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia.
Anaesthesia, critical care & pain medicine
|August 14, 2023
概括
使用贝叶斯预测软件的治疗药物监测 (TDM) 有效地实现了重症患者的目标抗生素暴露. 这种方法改善了抗生素剂量和临床治愈率,没有不良事件.
科学领域:
- 药理动力学和药理动力学
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
背景情况:
- 广谱抗生素,如β-乳糖胺和万科米对于重症患者至关重要.
- 低于最佳的抗生素暴露是常见的,可能导致治疗失败.
- 治疗药物监测 (TDM) 和贝叶斯预测软件可以优化抗生素剂量.
研究的目的:
- 评估剂量软件在达到目标抗生素暴露的效率.
- 评估软件引导剂量对危急病患者的万科米辛和β-乳治疗的影响.
主要方法:
- 在成人重症监护病房 (ICU) 进行前性队列研究.
- 包括接受万科米辛,皮佩拉西林-塔扎巴克坦或美罗的患者,其治疗水平低于或超过治疗水平.
- 使用ID-ODSTM剂量软件进行推,并重复TDM以确认目标的实现.
主要成果:
- 在70名分析患者中,80%的患者接受了软件建议.
- 86%的患者在一次软件引导剂量调整后达到目标抗生素暴露.
- 94%的患者实现了临床治愈,没有报告与抗生素暴露相关的不良事件.
结论:
- 与贝叶斯预测软件相结合的TDM提高了在ICU中实现目标抗生素暴露的效率.
- 需要进一步的临床试验来比较这种方法与替代剂量策略.
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