在现实世界儿科实践中使用伊萨夫可纳和TDM
Berta Fernández Ledesma1, Natalia Mendoza-Palomar1, Susana Melendo Pérez1
1Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Infantil. Vall d'Hebron Barcelona Hospital Campus, Institut de Recerca Vall d'Hebron, Barcelona, Catalonia, Spain.
Antimicrobial agents and chemotherapy
|November 14, 2023
概括
在儿童中用于侵入性真菌感染的伊萨夫可纳使用需要治疗药物监测. 许多患者,特别是那些接受ECMO治疗的患者,药物水平超出范围,这突显了需要仔细监测的必要性.
科学领域:
- 儿童传染病 儿童传染病
- 临床药理学 临床药理学
背景情况:
- 伊萨夫可纳 (ISA) 已被批准用于患有侵入性真菌感染的成年人,但在儿科患者中未经标签使用.
- 侵入性真菌感染对儿童构成重大风险,需要有效的治疗策略.
研究的目的:
- 评估Isavuconazole在患有侵入性真菌感染的儿科患者的实际使用情况.
- 评估治疗药物监测 (TDM) 的必要性和影响.
主要方法:
- 对15名接受伊萨夫可纳治疗的儿科患者的回顾性分析.
- 对所有患者进行治疗药物监测 (TDM),包括C_trough水平.
- 对TDM结果的分析,特别是在体外膜氧化 (ECMO) 患者中.
主要成果:
- 伊萨夫可纳被用于侵袭性真菌感染的15名儿科患者.
- 治疗药物监测显示,46.8% (52/111) 的C_trough确定在目标范围之外.
- 在接受ECMO的患者中,观察到更高比例的超标水平.
结论:
- 现实世界的数据支持在儿科侵袭性真菌感染中使用伊萨夫可纳.
- 治疗药物监测对于优化儿童Isavuconazole剂量至关重要.
- 由于改变了药理动力学,TDM对ECMO的儿科患者尤为重要.
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