克林达米辛与利芬素联合使用的剂量和使用途径
Sophie Magréault1, Racym Berrah2, Younes Kerroumi3
1Université Paris Cité and Université Sorbonne Paris Nord, Inserm UMR 1137, IAME, Paris, France; Unité Fonctionelle de Pharmacologie, GHU Paris Seine Saint-Denis, Assistance Publique-Hôpitaux de Paris, Université Sorbonne Paris Nord, Bondy, France.
利芬素显著影响了克林达米辛水平,降低了口服疗效. 建议静脉注射克林达米辛,特别是高剂量的连续输液,当与骨和关节感染相结合时,与里芬素相结合.
科学领域:
- 药理动力学 药理动力学
- 药物相互作用 药物相互作用
- 传染性疾病 传染性疾病
背景情况:
- 克林达米辛用于治疗骨和关节感染.
- 里芬素通常与克林达米辛联合使用.
- 这些药物之间的药理学相互作用尚未完全理解.
研究的目的:
- 开发一个药理动力学相互作用模型,用于克林达米辛和利芬皮辛.
- 为了评估适当的克林达米辛剂量和有效治疗途径,当与利芬素结合时.
主要方法:
- 来自124名患者的518个血样本的群体药理动力学分析.
- 蒙特卡洛模拟以评估实现目标的概率 (PTA).
- 评估克林达米的最低血度和曲线下的未结合面积与最小抑制度 (MIC) 的比率.
主要成果:
- 利芬素增加了克林达米辛清除的3倍,并且剂量取决于降低了生物可用性.
- 口服的克林达米辛与里芬皮辛并没有达到足够的度.
- 静脉注射 (IV) 克林达米辛3600毫克/天适用于>80%的患者;需要4800毫克/天才能达到S. aureus断点.
- 间歇性IV q6h比q8h更好,但连续输液更优越.
结论:
- 开发的模型准确地描述了利芬素对克林达米辛药理学效应的影响.
- 口服的克林达米辛不应与利芬皮辛一起使用.
- 需要高剂量的静脉克林达米辛 (≥3600毫克/天),最好是通过连续输注,以克服利芬素的影响.
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