Hayashi Hiroyuki, Matsuzaki Takashi, Saito Akio, Aoyama Takahiko, Matsumoto Yoshiaki
Department of Pharmacy, Yokohama City Seibu Hospital, St. Marianna University, Yasashi-cho, Asahi-ku, Yokohama, Japan.
Yakugaku Zasshi. 2008 Jan;128(1):81-7. doi: 10.1248/yakushi.128.81.
Three types of medication, Arbekacin, Vancomycin, and Teicoplanin, are used primarily to treat MRSA infections. These medications differ in their respective anti-bacterial actions, antibacterial spectrums, and pharmacokinetics. Proper use and dosage is required, and is based on patient background and the conditions of infection, among other factors. This study was conducted for a period of over one year at St. Marianna University School of Medicine, Yokohama City Seibu Hospital. It was designed to compare the conditions as they related to why doctors ordered a certain drug, the background, and their clinical examination values. The tendency to avoid selection of Arbekacin Sulfate (ABK) for patients who had kidney dysfunction was recognized, although there were a few exceptions made. Other than that, there were not any standard criteria set in selecting which medication to prescribe. Therefore, it is necessary to examine the appropriateness of the selection since ordering anti-MRSA medication seemed to depend on each doctor's own experience. Serum concentration was measured in order to avoid any side effects. Moreover, cases of young people, normal renal function and malignant tumor patients were recognized in which serum concentration of the anti-MRSA medications was not within the therapeutic range of therapeutic drug monitoring (TDM). This was to show that there is a possibility the medications involved were not sufficiently effective. Therefore, in the future it will be necessary to ensure that proper dosing instructions are followed.
三种药物，阿贝卡星、万古霉素和替考拉宁，主要用于治疗耐甲氧西林金黄色葡萄球菌（MRSA）感染。这些药物在各自的抗菌作用、抗菌谱和药代动力学方面存在差异。需要根据患者背景、感染情况等因素正确使用并确定剂量。本研究在横滨市西部医院圣玛丽安娜医科大学进行了一年多时间。其目的是比较与医生开具某种药物的原因、背景及其临床检查值相关的情况。虽然有少数例外情况，但已认识到对于肾功能不全患者倾向于避免选择硫酸阿贝卡星（ABK）。除此之外，在选择开具哪种药物时没有设定任何标准准则。因此，由于开具抗MRSA药物似乎取决于每位医生自身的经验，有必要检查选择的适当性。为避免任何副作用而测量了血清浓度。此外，还发现了一些年轻人、肾功能正常者和恶性肿瘤患者，其抗MRSA药物的血清浓度不在治疗药物监测（TDM）的治疗范围内。这表明所涉及的药物有可能疗效不足。因此，未来有必要确保遵循正确的给药说明。
