一个国际性的,多中心的药理学研究的协议,用于查重症监护单位的抗真菌暴露:SAFE-ICU研究
Jason A Roberts1,2,3, Fekade Sime1, Jeffrey Lipman1,3,4
1University of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.
概括
这项研究评估了当前的抗真菌药物剂量是否在重症患者中提供有效水平. 优化剂量对于改善真菌感染患者的生存和治疗结果至关重要.
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:
- 适当的抗真菌治疗对于患有真菌感染的重症患者的生存至关重要.
- 危急疾病可以显著改变药物药理动力学,可能导致药物暴露低于最佳水平.
- 在脆弱患者群体中,低于最佳的抗真菌暴露可能导致治疗失败和毒性增加.
研究的目的:
- 确定当前的抗真菌药物剂量方案是否能在重症患者中达到治疗性暴露.
- 评估该患者群体中药物暴露与最佳临床结果之间的关系.
- 为重症监护室 (ICU) 患者制定最佳的抗真菌剂量策略提供信息.
主要方法:
- 一项国际,多中心,观察性药理动力学研究,涉及成人重病患者.
- 被录取的患者接受了各种抗真菌药物 (可纳,伏利可纳,波萨可纳,伊萨武可纳,卡斯波金,米卡金,安尼杜拉金,安福特乙).
- 药理动力学采样发生在两个剂量间隔 (1-3日和4-7日),每次采样3个样本.
主要成果:
- 该研究描述了当代的抗真菌药物剂量和在重症患者中获得的药物暴露.
- 评估了与最佳疗效相关的药理动力学/药理动力学 (PK/PD) 目标暴露.
- 三十天死亡率被测量为一个关键的临床结果.
结论:
- 当代的抗真菌剂量可能无法始终达到与危急病患者最佳结果相关的暴露.
- 这些发现支持了针对重症患者群体量身定制的优化抗真菌剂量算法的需求.
- 优先优化药物剂量对于改善严重真菌感染的临床结果至关重要.
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