在儿科患者中优化个性化抗菌剂量:随机对照试验的系统审查和元分析
Nadir Yalçın1,2, Yağmur Dirik3, İzgi Bayraktar4
1Department of Clinical Pharmacy, Faculty of Pharmacy, Hacettepe University, 06100, Ankara, Turkey. nadir.yalcin@hotmail.com.
治疗药物监测 (TDM) 在儿科患者中显著改善了抗微生物标的实现. 需要对度目标干预 (TCI) 进行更多的研究,以提高治疗结果和安全性.
科学领域:
- 药理学 药理学是指药理学的学科.
- 儿科 儿科 儿科
- 临床药房 临床药房
背景情况:
- 个性化医学利用治疗药物监测 (TDM) 和度干预 (TCI) 来优化药物剂量.
- 这些方法解决了患者的变异性,以提高治疗疗效和减少不良影响.
研究的目的:
- 评估TDM和TCI的随机对照试验 (RCT) 针对儿童个性化抗菌剂量.
- 重点是比较不同剂量方案及其对血度,疗效和安全的影响.
主要方法:
- 在主要数据库 (MEDLINE,Embase,Web of Science,Cochrane) 进行了系统的搜索,直到2024年1月.
- 包括儿科患者 (18岁以下) 的同行评审RCT,比较实验性与标准抗菌剂剂量与TDM或TCI.
- 主要结局是达到度目标;次要结局包括临床缓解,治疗失败和不良反应.
主要成果:
- 分析了11个基于TDM的RCT,涉及1155名儿科患者.
- 实验用剂量显著改善了目标度的达到 (RR 1.26,p=0.0051).
- 在治疗失败,临床缓解或实验剂量不良反应方面没有观察到显著改善.
结论:
- 治疗药物监测 (TDM) 显著提高了儿童抗微生物治疗的度目标.
- 需要更大的以TCI为重点的RCT来证明治疗失败,不良反应和临床缓解的显著改善.
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