现实世界的达普托米辛使用,重点关注肌肉毒性:一个多中心的回顾性研究
C Airaud1, E Demay2, V Dias Meireles3
1CHU Poitiers, F-86000, Poitiers, France.
International journal of antimicrobial agents
|January 24, 2026
概括
用达普托米辛治疗格拉姆阳性感染的安全性监测不一致,增加肌肉毒性风险. 同时处方他类药物,纤维酸或肥胖独立地提高了这种风险,需要仔细审查药物和CK测试.
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
- 传染性疾病 传染性疾病
背景情况:
- 达普托米辛是格拉姆阳性感染的关键抗生素.
- 肌肉毒性是达普托米辛治疗的已知副作用之一.
- 在现实世界中,对达普素安全监测指南的遵守尚未得到充分证实.
研究的目的:
- 评估法国大学医院的达普素处方模式.
- 为了确定与达普胺诱导的肌肉毒性相关的因素.
- 评估安全监测实践的一致性.
主要方法:
- 对1407名成年患者进行了回顾性多中心研究,这些患者接受了达普米治疗.
- 收集有关人口统计,治疗,监测和不良事件的数据.
- 肌肉毒性由肌酸激酶 (CK) 升高或狂犬病溶解定义;用于风险因素分析的逻辑回归.
主要成果:
- 在93.9%的患者中使用高剂量达普托米辛 (≥8 mg/kg/day).
- 只有34.2%的患者进行了CK监测.
- 报告的肌肉毒性为4.9%,包括2.7%的狂犬病.
- 同时使用他类药物/纤维酸盐 (OR 6.68) 和肥胖 (OR 2.25) 是肌肉毒性的重要危险因素.
结论:
- 尽管使用高剂量,但daptomycin安全性监测,特别是CK测试是不一致的.
- 系统的CK监测和对肌肉毒性联合药物的仔细评估至关重要.
- 缓解与达普素相关的肌肉毒性需要警的临床实践.
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