高剂量达普托米辛在肥胖患者中的安全性:一个多中心的回顾性研究
Vasco Dias Meireles1,2, Clémentine Airaud3, Elouan Demay4
1Service de Pharmacie Clinique, CHU de Bordeaux, Bordeaux, F-33076, France. vasco-antonio.dias-meireles@chu-bordeaux.fr.
概括
接受高剂量达普素的肥胖患者面临显著更高的不良事件 (AE) 风险,包括肌酸激酶 (CK) 水平升高. 在这个人群中,调整体重的剂量可以减轻这些风险.
科学领域:
- 药理学 药理学是指药理学的学科.
- 临床医学 临床医学
- 患者安全 患者安全
背景情况:
- 肥胖与药物药理学变化有关,可能增加不良事件 (AE) 风险.
- 达普托米辛是一种抗生素,用于严重的格拉姆阳性感染,但在高剂量的肥胖患者中,它的安全性需要进一步调查.
- 之前的研究表明,在标准剂量下,肥胖患者的达普托米辛暴露增加,这引发了对更高剂量的担忧.
研究的目的:
- 评估高剂量达普托米辛 (10毫克/公斤) 在肥胖患者中的安全性.
- 在接受高剂量达普托米辛的肥胖患者中识别与不良事件 (AE) 相关的危险因素.
- 为了比较肥胖和非肥胖患者之间治疗高剂量达普托米辛的AE率.
主要方法:
- 多中心,回顾性观察性研究.
- 包括BMI>30 kg/m2 (肥胖) 的患者,并与非肥胖患者进行比较.
- 评估不良事件,包括肌酸激酶 (CK) 升高,乙性肺炎和肝酶升高;进行单变量和多变量分析.
主要成果:
- 与非肥胖患者 (970) (3.5%) 相比,肥胖患者 (333) 的AE率显著更高 (8.7%).
- 肥胖患者的CK水平显著上升,CK水平严重升高.
- 副作用的风险因素包括肥胖,并发性狂犬病风险药物,中度功能障碍 (eGFR30-60毫升/分钟) 和达普托米辛持续时间;传染病专家咨询降低了风险.
结论:
- 肥胖患者在接受高剂量达普托米辛治疗时,副作用的风险显著增加.
- 建议在肥胖患者中考虑调整体质剂量策略,以最大限度地降低AE风险.
- 为了确保患者的安全性和治疗疗效,需要进一步研究优化肥胖人群中的达普托米辛剂量.
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