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个体美罗烯上皮层液体和血PK/PD目标的实现
Roxane Rohani1, Paul R Yarnold2, Marc H Scheetz3,4,5
1Discipline of Cellular and Molecular Pharmacology, Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA.
Antimicrobial agents and chemotherapy
|November 17, 2023
概括
血药物度可能不准确地反映表皮层内液 (ELF) 梅罗胺度. 加重剂量和较低的肌素清除率影响目标的实现,强调需要谨慎的剂量策略.
科学领域:
- 药理动力学和药理动力学
- 传染性疾病 传染性疾病
- 临界护理医学 临界护理医学
背景情况:
- 表面膜液 (ELF) 药物度对于有效的抗生素治疗至关重要,但血水平通常被用作替代品.
- 血梅罗胺度用于预测ELF目标达到的可靠性仍然不清楚.
研究的目的:
- 为了比较使用潜在患者样本的等离子体中的美罗胺目标达标与ELF.
- 评估患者特异性和人口层面因素对美罗的药理动力学/药理动力学 (PK/PD) 目标的影响.
主要方法:
- 从接受美罗胺的患者中收集血和ELF样本的前景采集.
- 在1xMIC和4xMIC目标下,在最低抑制度 (T>MIC) 以上24小时时间的评估.
- 分析患者水平 (固定的MIC) 和人口水平 (累计反应分数 - CFR) 的目标.
主要成果:
- 血高估了高达30%的患者的ELF目标达到.
- 较高的肌素清除率 (>115毫升/分钟) 与ELF目标实现的减少有关.
- 负载剂量显著增加了Pseudomonas aeruginosa在血和ELF中的CFR.
结论:
- 血梅罗胺度不是ELF目标实现的可靠替代品.
- 患者的因素,如肌素清除率和加重剂量的使用,会影响美罗的疗效.
- 优化剂量策略,可能包括加载剂量,是必要的,以确保足够的ELF药物暴露.
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