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在接受ECMO治疗的患者中,Ceftazidime/avibactam的血清度
Anaïs Curtiaud1, Matthieu Petit1, Juliette Chommeloux1
1Service de médecine Intensive Réanimation, Sorbonne Université, Groupe Hospitalier Pitié-Salpêtrière, Institut de Cardiologie, Assistance Publique-Hôpitaux de Paris, Paris, France.
在体外膜氧化 (ECMO) 患者中,塞夫塔齐/阿维巴克坦水平通常保持在适当水平. 然而,干净度增加可能导致这些关键抗生素的剂量不足,风险治疗失败.
科学领域:
- 药理学 药理学是指药理学的学科.
- 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:
- 体外膜氧化 (ECMO) 可以改变药物的药理动力学,可能导致抗生素剂量不足和治疗失败.
- 关于ECMO患者新型抗微生物药物的药理动力学数据有限,例如ceftazidime/avibactam.
研究的目的:
- 为了评估ECMO接受ECMO的患者的血中Ceftazidime和Avibactam水平.
- 为了确定与ECMO治疗期间可能低剂量的塞夫塔齐/阿维巴克坦相关的因素.
主要方法:
- 对14名ECMO患者进行了回顾性观察性研究,这些患者接受了ceftazidime/avibactam.
- 测量了塞夫塔齐和阿维巴克坦的血水平,并与欧洲抗菌感应性测试委员会 (EUCAST) 的断点进行了比较.
- 分析了与低剂量相关的因素,重点是干净度.
主要成果:
- 在接受静脉ECMO治疗SARS-CoV-2肺炎的患者中,分析了23个ceftazidime/avibactam的最低水平.
- 大多数患者 (13/14) 的塞法胺水平充足,但39% (9/23) 的阿维巴克坦水平低于EUCAST的4mg/L断点.
- 清除率升高 (肌素清除率>130毫升/分钟) 被确定为与低剂量相关的关键因素,在70%的亚治疗性阿维巴克坦水平中观察到.
结论:
- 在ECMO患者中,tazidime/avibactam的血清水平通常高于EUCAST断点,支持标准剂量方案.
- 增加干净度是ECMO患者中塞夫塔齐/阿维巴克坦剂量不足的重要危险因素.
- 密切监测抗生素水平和功能对于优化ECMO患者的Ceftazidime/avibactam治疗至关重要.
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