与儿科重症败血症中早期达到美罗胺目标相关的药理动力学因素
Kelli Paice1,2, Sonya Tang Girdwood2,3,4, Tomoyuki Mizuno2,4
1Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
在儿科重症败血症中,大多数儿童都实现了早期的美罗胺度目标. 更高的药物清除与未能达到治疗目标有关,这表明需要在重症儿童中个性化剂量策略.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 药理动力学和药理动力学
- 传染性疾病 传染性疾病
背景情况:
- 重症儿童的严重败血症需要有效的抗菌药物治疗.
- 达到治疗性药物度对于最佳结果至关重要.
- 梅罗胺是一种广泛的抗生素,用于严重的细菌感染.
研究的目的:
- 为了确定早期度目标 (TA) 在患有严重败血症的重症儿童中的早期度目标 (TA) 的频率.
- 探索与TA相关的因素,包括临床,治疗和药物动力学变量.
- 评估液体复苏,体积状态和早期TA之间的关系.
主要方法:
- 对前性观察队列研究的回顾性分析.
- 包括29名患有严重败血症的重症儿童接受梅洛.
- 使用群体药动力学建模和贝叶斯估计分析度-时间概况.
主要成果:
- 29名患者中有21名 (72%) 实现了超过4倍最小抑制度 (MIC) 的40%时间的目标.
- 较高的美罗胺清除率与未能达到治疗目标有关.
- 没有发现TA与分布量,年龄,体重,eGFR或液体给药之间有显著的关联.
结论:
- 严重败血症的儿科患者中很大一部分没有达到早期的美罗胺治疗目标.
- 较高的药物清除率是与未能达到美罗胺目标相关的关键因素.
- 对于重症儿童来说,可能需要个性化的美罗胺剂量策略,以优化目标的实现.
更多相关视频
11:17Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
Published on: August 30, 2018
09:26Antibiotic Efficacy Testing in an Ex vivo Model of Pseudomonas aeruginosa and Staphylococcus aureus Biofilms in the Cystic Fibrosis Lung
Published on: January 22, 2021
相关概念视频
Nonlinear Pharmacokinetics: Dependence of Elimination Half-Life and Dose Clearance
A study on guinea pigs examined the...
Factors Affecting Drug Response: Overview
Drug Concentration Versus Time Correlation
Two pivotal parameters are the minimum effective concentration (MEC) and the minimum toxic concentration (MTC). The MEC is the...
Factors Affecting Drug Distribution: Miscellaneous Factors
Age plays a significant role due to differences in body composition among different age groups. Infants, for instance, have a higher proportion of total body water and lower albumin levels, a protein that binds drugs in the bloodstream. This unique composition in infants enhances the...
Factors Affecting Drug Distribution: Tissue Permeability
Small molecules with a molecular weight below 500 to 600 Daltons can easily pass through the capillary membrane, gaining access to different tissues. Larger...
Chronopharmacokinetics: Circadian Rhythms and Influence on Drug Response
The time of drug administration is an important factor to consider, as it can influence the toxic dose of a drug. For example, a study conducted by Prins et al. in 1997 examined the effects of the timing of...
