赛斯塔丁C导向剂量诺莫图改善了重症患者对塞费皮姆的目标达到
Erin F Barreto1, Marc H Scheetz2,3, Jack Chang4
1Department of Pharmacy, Mayo Clinic, Rochester, MN.
Critical care medicine
|February 27, 2025
概括
使用联合肌素和细胞素C估计的淋巴细胞过率 (eGFRcr-cys) 的新的cefepime剂量名图改善了重症患者的标药物水平. 这种方法可以提高cefepime的有效性,同时最大限度地降低毒性药物度的风险.
科学领域:
- 药理学和重症监护医学 药理学和重症监护医学
- 功能估计 功能估计
- 抗生素剂量优化 抗生素剂量优化
背景情况:
- 估计的淋巴细胞过率 (eGFR) 对于重症患者的药物剂量至关重要.
- 基于肌素的eGFR (eGFRcr) 在这个人群中可能不那么准确.
- 结合肌素和囊素C eGFR (eGFRcr-cys) 为功能评估提供了更高的准确性.
研究的目的:
- 开发和评估使用eGFRcr-cys用于重症成年人初始剂量的cefepime剂量计.
- 为了比较诺莫格拉姆指导的塞费皮姆剂量与标准剂量的疗效和安全性.
主要方法:
- 药物动力学建模和仿真研究.
- 基于eGFRcr-cys和患者体重的诺米克图的开发.
- 预测的100%自由塞费皮姆度在24小时内超过最小抑制度 (MIC) (ƒT>MIC) 和度-时间曲线下的自由区域 (ƒAUC0-24) 的比较.
主要成果:
- 诺米图显著改善了预测的100% ƒT>MIC在24小时内 (76%对38%,p <0.001).
- 与服用剂量 (612 mg·hr/L; p = 0.01) 相比,诺莫克 (666 mg·hr/L) 的中位数 ƒAUC0-24 略高.
- 诺米图减少了过高或过低的AUC0-24值的发生率 (7%对20%,p=0.004).
结论:
- 一个包含eGFRcr-cys的cefepime剂量表可以提高重症患者的目标达到.
- 这种方法可以提高cefepime的治疗疗效,而不会显著增加毒性风险.
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