通过持续的低效率透析去除常见的抗菌剂
Joanna Q Hudson1,2, Madelyn N Hilgers1, Elvira O Gosmanova2
1Department of Clinical Pharmacy and Translational Science, The University of Tennessee Health Science Center, Memphis, Tennessee, USA.
Antimicrobial agents and chemotherapy
|February 13, 2024
概括
持续低效透析 (SLED) 在重症患者中显著消除了常见的抗生素,如cefepime,meropenem和vancomycin. 在SLED期间,剂量调整至关重要,以保持有效的抗微生物水平并防止治疗失败.
科学领域:
- 药理动力学 药理动力学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 关键护理医学 关键护理医学
背景情况:
- 优化抗微生物剂量对患有功能障碍的重症患者至关重要.
- 关于持续低效率透析 (SLED) 期间抗菌素去除的数据有限.
研究的目的:
- 在SLED过程中量化关键抗菌剂 (cefepime, daptomycin, meropenem, piperacillin-tazobactam, vancomycin) 的去除.
- 评估SLED对抗微生物药理学的影响,包括清除和半衰期.
主要方法:
- 对患有AKI或ESRD的成年患者进行了一项研究,需要SLED并接受选择的抗微生物药物.
- 在SLED期间每小时同时采集动脉和静脉血液样本,在SLED期间每小时采集动脉样本,并在SLED之外采集动脉样本进行药理学分析.
- 计算的SLED清除值,半衰期在SLED和非SLED上,以及通过SLED (fD) 清除的分数.
主要成果:
- 与非SLED条件相比,SLED显著减少了所有评估的抗微生物药物的半衰期.
- 通过SLED (fD) 清除抗菌素的比例在研究药物中从44%到77%不等.
- 一个8小时的SLED会话导致了大部分测试的抗菌素的大量消除.
结论:
- 在重症患者中,SLED导致显著的抗微生物清除.
- 抗菌剂剂量方案需要在SLED期间进行修改,以防止亚治疗性药物度.
- 需要进一步的研究来确定SLED期间抗微生物药物的最佳剂量策略.
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