Lipka Bozena, Milewska-Bobula Bogumila, Filipek Marian
Department of Infant Diseases, The Children's Memorial Health Institute, 20 Dzieci Polskich Avenue, 04-730 Warsaw, Poland.
Wiad Parazytol. 2011;57(2):87-92.
The study objective was to determine plasma concentration of pyrimethamine in 24 infants aged 1-5 months, treated for congenital toxoplasmosis. Pyrimethamine was used in a single daily dose at an amount of 0.35-0.98 mg/kg daily, with sulfadiazine (50-100 mg/kg/day) in divided doses 2-3 times a day, and folinic acid given twice a week (7.5 mg). This regimen was continued for 2-6 months, then Fansidar was administered. Pyrimethamine concentration in plasma was measured using high-performance liquid chromatography method (HPLC). A total of 70 tests were performed. Concentration of pyrimethamine ranged from 0.01 to 1.2 microg/ml. In 14 children (58 tests) the concentration of pyrimethamine achieved therapeutic value. In 7 patients (8 tests) the concentration was below therapeutic level, and in 3 patients (4 tests) above therapeutic level. In 11/24 (46%) children transient moderate neutropenia was observed. Modification of therapy was necessary in 12 patients. Monitoring of pyrimethamine concentration in plasma improves safety and effectiveness of the therapy and is useful in obtaining correct individual dose of the drug. Neutropenia is the most common side-effect of pyrimethamine observed even when using the recommended dose.
该研究的目的是测定24名年龄在1至5个月、接受先天性弓形虫病治疗的婴儿的血浆乙胺嘧啶浓度。乙胺嘧啶每日单次给药，剂量为0.35 - 0.98毫克/千克/天，同时联用磺胺嘧啶（50 - 100毫克/千克/天），分2至3次给药，亚叶酸每周给药两次（7.5毫克）。该治疗方案持续2至6个月，之后给予 Fansidar。采用高效液相色谱法（HPLC）测定血浆中的乙胺嘧啶浓度。共进行了70次检测。乙胺嘧啶浓度范围为0.01至1.2微克/毫升。14名儿童（58次检测）的乙胺嘧啶浓度达到治疗值。7名患者（8次检测）的浓度低于治疗水平，3名患者（4次检测）的浓度高于治疗水平。11/24（46%）的儿童出现短暂性中度中性粒细胞减少。12名患者需要调整治疗方案。监测血浆中乙胺嘧啶浓度可提高治疗的安全性和有效性，有助于确定正确的个体用药剂量。中性粒细胞减少是乙胺嘧啶最常见的副作用，即使使用推荐剂量也会出现。
