在重症犬中静脉注射安皮西林/苏尔巴克坦具有可变的药理动力学
Robert Goggs1,2, Sarah Robbins1, Julie Menard3
1Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA.
Journal of veterinary pharmacology and therapeutics
|June 13, 2025
概括
接受安比西林/苏尔巴克坦治疗的重症狗符合抗菌药物 (AMD) 治疗的兽医标准. 然而,由于血度低,剂量可能不足以治疗肠杆菌感染.
科学领域:
- 兽医药理学 兽医药理学
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
背景情况:
- 达到抗微生物药物 (AMD) 的治疗性血度对于有效治疗至关重要,特别是在危急病患者中.
- 危急疾病可以显著改变药物药理动力学 (PK),可能危及AMD的疗效.
- 西林/苏尔巴克坦是常用的,但其关键病犬的PK和疗效目标需要评估.
研究的目的:
- 为了评估静脉注射 (IV) 西林/苏尔巴克坦在重病狗中的药理动力学 (PK).
- 为了确定未结合的血药物度超过最小抑制度 (MIC) 在剂量间隔≥50%的目标疗效的实现.
- 用蒙特卡洛模拟来评估各种细菌MIC的目标实现 (PTA) 的概率.
主要方法:
- 一项前性观察性研究,涉及25只重症狗接受静脉安西林/硫黄 (20毫克/公斤安西林/10毫克/公斤硫黄).
- 血中药物度用液体染色学质谱法测量.
- PK 建模 (安培西林为一间隔,硫巴为两间隔) 和蒙特卡洛模拟来预测 PTA.
主要成果:
- 皮素PK最好用一个单间模型描述;sulbactamPK用一个双间模型描述.
- 蒙特卡洛模拟显示,在兽医CLSI断点 (0.25微克/毫升) 上,安皮西林的PTA为90%,但在人类断点 (8微克/毫升) 上,PTA仅为10%.
- 在0.25μg/mL下,大多数肠杆菌分离物很可能具有耐药性.
结论:
- 经测试的安培/苏尔巴克坦剂量 (20 mg/kg IV q8h) 符合当前兽医CLSI对安培的标准.
- 这种剂量可能不足以有效治疗严重病情的狗的肠杆菌感染,因为血度低于最佳水平.
- 需要进行进一步的研究,以优化危急病患者的安皮西林/苏尔巴克坦剂量方案.
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