基于模型的精确剂量改善了接受万科米辛治疗格兰氏阳性感染的患者的治疗结果
Nicole M Hall1, Matthew L Brown1, W Seth Edwards1
1Department of Pharmacy, UAB Hospital, Birmingham, Alabama, USA.
Open forum infectious diseases
|January 22, 2024
概括
基于模型的精确剂量 (MIPD) 与曲线下的面积 (AUC) 导向的万通治疗改善了患者的治疗结果,并减少了急性损伤. 这种方法可以更早地评估和更灵活地监测万科米辛水平.
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
- 临床药房 临床药房
背景情况:
- 目前的范科米辛剂量指南建议两种血清度用于估计曲线下的面积与最小抑制度 (AUC/MIC) 的比率.
- 贝叶斯软件可实现基于模型的精确剂量 (MIPD) 用于使用单个康胺度进行治疗药物监测,但支持数据有限.
研究的目的:
- 为了比较以AUC为指导的万科米辛治疗的疗效和安全性,使用MIPD与单一度监测与传统的低谷指导治疗相比.
- 为了评估治疗的成功,与万科米辛相关的急性损伤 (VA-AKI) 和住院患者的死亡率.
主要方法:
- 在300名成年患者的回顾性研究中,300名成年患者患有格拉姆阳性感染,接受万科米辛治疗≥72小时.
- 患者被分为以AUC为导向 (MIPD,单一度) 和低谷为导向的治疗组.
- 使用结果排名分析的可取性来比较结果,优先考虑治疗成功的生存率,而不是VA-AKI.
主要成果:
- 以AUC为指导的组显示了最理想结果的更高率 (58.7%对46.7%,P = .037).
- 在以AUC为指导的组中,VA-AKI的发病率明显较低 (21.3%对32.0%,P = .037).
- 在接受AUC导向治疗的患者中,住院时间的中位数较短 (10天对12天,P = .025).
结论:
- 使用MIPD进行AUC引导的万科米辛治疗改善了临床结果,并降低了格兰美阳性感染患者的VA-AKI.
- MIPD有助于更早地评估AUC目标的实现,并提供了更大的灵活性,以监测万科米辛.
- 在以AUC为指导的方法中,没有发现有效性降低的担忧.
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