亚胺培南西司他丁钠和米卡芬净钠治疗呼吸机相关性肺炎的疗效观察
Colistin methanesulfonate and colistin pharmacokinetics in critically ill patients receiving continuous venovenous hemodiafiltration.
机构信息
Department of Medical Sciences, Section for Infectious Diseases, Uppsala University, Uppsala, Sweden.
出版信息
Antimicrob Agents Chemother. 2013 Jan;57(1):668-71. doi: 10.1128/AAC.00985-12. Epub 2012 Nov 12.
Abstract
This report describes the pharmacokinetics of colistin methanesulfonate (CMS) and colistin in five intensive care unit patients receiving continuous venovenous hemodiafiltration. For CMS, the mean maximum concentration of drug in plasma (C(max)) after the fourth dose was 6.92 mg/liter and total clearance (CL) 8.23 liters/h. For colistin, the mean concentration was 0.92 mg/liter and CL/metabolized fraction (f(m)) 18.91 liters/h. Colistin concentrations were below the current MIC breakpoints, and the area under the concentration-time curve for the free, unbound fraction of the drug over 24 h in the steady state divided by the MIC (fAUC/MIC) was lower than recommended, suggesting that a dosage regimen of 160 mg CMS every 8 h (q8h) is inadequate.
摘要
本报告描述了 5 名在重症监护病房接受连续静脉-静脉血液透析滤过的患者中，甲磺酸粘菌素（CMS）和粘菌素的药代动力学。对于 CMS，第四次给药后的血浆中药物最大浓度（C(max)）均值为 6.92 毫克/升，总清除率（CL）为 8.23 升/小时。对于粘菌素，平均浓度为 0.92 毫克/升，CL/代谢分数（f(m)）为 18.91 升/小时。粘菌素的浓度低于当前的 MIC 折点，稳态下药物游离、未结合部分的 24 小时浓度-时间曲线下面积与 MIC 的比值（fAUC/MIC）低于推荐值，表明每 8 小时给予 160 毫克 CMS（q8h）的剂量方案不足。
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