使用AUC/MIC协议在间歇性血液透析 (IHD) 末期脏病 (ESRD) 患者中开发和评估万科米辛剂量
Mary Ables1, Ron W Welch1, Brittany Walley1
1Department of Pharmacy, Baptist Memorial Hospital GTR, Columbus, MS, USA.
Journal of pharmacy practice
|September 16, 2023
概括
在间歇性血液透析 (IHD) 治疗末期病 (ESRD) 患者中,优化范素剂量对于治疗耐甲素黄金葡萄球菌 (MRSA) 感染至关重要. 新的协议旨在提高透析前水平,以达到目标AUC/MIC比率,改善结果.
科学领域:
- 药理学 药理学是指药理学的学科.
- 腎臟病學 (nephrology) 是一種醫學.
- 传染性疾病 传染性疾病
背景情况:
- 耐美西林黄金葡萄球菌 (MRSA) 感染是接受间歇性血液透析 (IHD) 的末期病 (ESRD) 患者死亡的重要原因.
- 优化万科米辛的剂量对于提高疗效和最大限度地减少这种脆弱人群中的毒性至关重要.
- 目前的指导方针主张使用曲线下的面积 (AUC) /最小抑制度 (MIC) 剂量策略,目标为400-600.
研究的目的:
- 评估目前的万科米辛剂量协议在ESRD患者的有效性.
- 开发和评估一种新的万科米辛剂量协议,使用针对该患者群体量身定制的AUC/MIC目标.
- 改善治疗结果和减少与万科米辛治疗相关的不良事件.
主要方法:
- 在两个阶段进行了回顾性图表审查.
- 第一阶段评估了现有的万科米辛剂量协议.
- 第二阶段评估了一项新开发的协议,使用AUC/MIC目标在成年住院患者ESRD接受IHD和vancomycin.
主要成果:
- 该研究的目的是确定20-25 mg/dL的透析前万科米辛水平,与480-600的AUC/MIC相关.
- 这个目标不同于标准的17-25毫克/分升,可能是由于ESRD患者免疫功能下降.
- 新协议的重点是更快地达到和维持治疗性万科米辛水平.
结论:
- 调整的万科米辛剂量目标是必要的ESRD患者在IHD考虑改变免疫功能.
- 快速实现目标AUC/MIC比率对于改善MRSA治疗结果至关重要.
- 优化的万科米辛剂量可以减少这种高风险人群的不良事件和医疗保健成本.
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