列沃素的药理动力学:早期临床试验的新范式
S L Preston1, G L Drusano, A L Berman
1Department of Medicine, Albany Medical College, NY 12208, USA.
JAMA
|January 24, 1998
概括
这项研究发现,高峰利沃素度与病原体最小抑制度 (MIC) 的比率显著预测了成功的治疗结果. 至少12.2的峰值/MIC比率与最佳的临床和微生物反应有关.
科学领域:
- 药理学 药理学是指药理学的学科.
- 传染性疾病 传染性疾病
- 临床试验 临床试验
背景情况:
- 确定最佳的抗生素剂量对于第三期临床试验至关重要.
- 将药物暴露与病原体易感性 (MIC) 联系起来可以指导剂量选择.
- 早期的药理动力学有效性建模有助于最大限度地提高治疗反应.
研究的目的:
- 量化勒沃素血水平与患者结果之间的关系.
- 评估levofloxacin暴露和不良事件之间的相关性.
- 确定最佳的暴露值,以获得有利的临床和微生物学结果.
主要方法:
- 一个多中心的开放标签试验,涉及313名细菌感染的患者.
- 分析了血度-时间数据和病原体MIC.
- 后勤回归模拟了峰值/MIC比率与结果之间的关联.
主要成果:
- 峰值/MIC比率和感染部位预测了临床结果 (P<.001).
- 峰值/MIC比率预测了微生物根除 (P<.001).
- 在峰值/MIC比率≥12.2.2的情况下,最有可能出现有利的结果.
结论:
- 利沃撒获得了高的临床 (95%) 和微生物 (96%) 反应率.
- 药物暴露与成功治疗结果有显著的联系.
- 药理动力学建模可以加快剂量优化并改善患者的治疗结果.
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