在门置换手术期间,塞法林预防的外科手术期间的药理动力学
Ahmad Alli1, Fathima Paruk2, Claire Roger3,4
1Department of Anesthesiology and Pain Medicine, St Michael's Hospital, University of Toronto, Toronto, Canada.
PloS one
|September 20, 2023
概括
标准的塞法林剂量不足以在心肺旁路手术 (CPB) 期间进行抗生素预防. 需要更高的剂量或更频繁的使用,以确保抗常见病原体的药物度足够.
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
- 心血管外科心血管外科
背景情况:
- 对于心肺绕道 (CPB) 期间的抗生素预防剂量存在有限的前性数据.
- 在CPB期间了解塞法林的药理动力学 (PK) 对于优化手术部位感染 (SSI) 预防至关重要.
研究的目的:
- 在CPB期间评估塞法林的种群药理学.
- 为了确定目前的塞法佐林剂量方案在实现目标抗微生物暴露的有效性.
- 为CPB手术推最佳的塞法林剂量策略.
主要方法:
- 使用了人口PK建模和蒙特卡洛模拟.
- 对16名用CPB进行心脏门置换的患者的总和未结合的塞法佐林度的分析.
- 对抗关键病原体的最小抑制度 (MIC) 以上100%时间的分数目标实现 (FTA) 的计算.
主要成果:
- 一个三部分线性PK模型描述了塞法林度.
- 标准的2g每4小时的塞法林剂量不足以达到100%的FTA 黄金葡萄球菌和大肠杆菌在低血清肌水平.
- 即使使用更高的模拟剂量,也无法获得足够的FTA用于Staphylococcus epidermidis.
结论:
- 目前的塞法林预防 (2g每4小时) 对于CPB手术是不够的,特别是在正常功能患者中.
- 优化剂量需要增加塞法林剂量和/或频率,以确保有效的预防.
- 在CPB期间对塞法林剂量的进一步研究是有必要的.
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