甲素抗金黄色葡萄球菌的细菌病治疗的万科米辛计算的面积-曲线下在患者高万科米辛最小抑制度的患者
Sarah Arnold1, Dustin Orvin2, Malay Patel3
1MUSC Health Columbia Medical Center Downtown, Columbia, SC, USA.
Hospital pharmacy
|May 20, 2024
概括
针对MRSA细菌病的万科米辛剂量在MIC>1mcg/mL时,基于AUC和基于低谷的方法之间的治疗失败没有差异. AUC 剂量可能会降低万科米辛暴露和毒性,但不会影响结果.
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:
- 范科米辛是推的第一线治疗抗甲素耐药黄金葡萄球菌 (MRSA) 细菌.
- 目前的剂量指南建议基于曲线下面积 (AUC) 的剂量,通过汁微稀释,假定最小抑制度 (MIC) 为1μg/ml.
- 然而,较高的MIC可能会影响治疗的有效性.
研究的目的:
- 为了比较基于AUC和基于低谷的万科米辛剂量的有效性,在患有MRSA细菌病症和MIC> 1mcg/mL的患者中.
- 为了评估两种剂量策略之间的治疗失败,毒性和药物暴露的差异.
主要方法:
- 追溯性,观察性队列研究,通过AUC或低谷比较万科米辛剂量.
- 2017年1月1日至2022年9月1日期间收集的患者数据.
- 主要结局:治疗失败的组合 (持续的细菌病,90天的死亡率,30天的复发/再入院). 二次结果:毒性,停留时间,MIC和AUC暴露.
主要成果:
- 在低谷和AUC组之间没有观察到治疗失败的统计学上显著差异 (41.7%).
- 二次结果,包括毒性发病率和中位数AUC暴露,在两组之间是相似的.
- 在最低剂量组中,观察到数字上更高的万科米辛暴露和毒性.
结论:
- 无论是基于AUC还是基于低谷的万科米辛剂量都没有显示出MRSA细菌病治疗失败的统计学上显著的差异,Etest MIC>1mcg/mL.
- 基于AUC的剂量可能会限制万科米辛的暴露,并降低毒性,而不会影响治疗疗效.
- 进一步的研究可能有必要,以优化针对特定患者群体和MIC值的万科米辛剂量策略.
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