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基于血药峰浓度/最低抑菌浓度的硫酸阿贝卡星临床研究

[Clinical investigation of arbekacin sulfate based on Cmax/MIC].

作者信息

Kimura Masao, Yamagishi Yuka, Kawasumi Noriyo, Mikamo Hiroshige

机构信息

Department of Infection Control and Prevention, Aichi Medical University.

出版信息

Jpn J Antibiot. 2012 Aug;65(4):263-9.

Abstract

We examined the peck concentration (Cmax)/minimal inhibitory concentration (MIC) and the clinical efficacy in methicillin-resistant Staphylococcus aureus (MRSA) pneumonia and Gram-positive cocci bacteremia. We evaluated arbekacin (ABK) on 22 cases of pneumonia and 10 cases of bacteremia in Aichi Medical University Hospital between August 2008 and July 2011, retrospectively. In pneumonia cases, Cmax/MIC was 16.4 +/- 2.8 in the effective group, and was 17.6 +/- 4.5 in the not effective group, the significant differences were not accepted (p = 0.8). The dosage of ABK was 4.7 +/- 1.4 mg/kg/dose in the effective group and was 4.3 +/- 0.7 mg/kg/dose in the not effective group. In bacteremia cases, Cmax/MIC was 24.2 +/- 13.9 in the effective group and 12.9 +/- 3.9 in the not effective group about clinical efficacy, and the high tendency was accepted by the effective group (p < 0.05). The dosage of ABK was 3.4 +/- 1.1 mg/kg/dose in the effective group, and 3.0 +/- 0.6 mg/kg/dose in the not effective group. In this examination, the significant difference was not observed in clinical efficacy and Cmax/MIC in the pneumonia cases. Although it was reported that clinical efficacy of ABK was given Cmax/MIC at eight or more, in this examination, all cases was eight or more at Cmax/MIC, and the clinical effect was 40.9%. On Cmax/MIC of ABK, clinical effective group was higher than not effective group in bacteremia cases, it was suggested that the administration design should make that Cmax/MIC at least about 14 or more would be necessary.

摘要

我们研究了耐甲氧西林金黄色葡萄球菌(MRSA)肺炎和革兰氏阳性球菌菌血症中匹克浓度(Cmax)/最低抑菌浓度(MIC)以及临床疗效。我们回顾性评估了2008年8月至2011年7月期间爱知医科大学医院22例肺炎和10例菌血症患者使用阿贝卡星(ABK)的情况。在肺炎病例中,有效组的Cmax/MIC为16.4±2.8,无效组为17.6±4.5,差异无统计学意义(p = 0.8)。有效组ABK的剂量为4.7±1.4mg/kg/剂量,无效组为4.3±0.7mg/kg/剂量。在菌血症病例中,就临床疗效而言,有效组的Cmax/MIC为24.2±13.9,无效组为12.9±3.9,有效组有升高趋势(p < 0.05)。有效组ABK的剂量为3.4±1.1mg/kg/剂量,无效组为3.0±0.6mg/kg/剂量。在本次研究中,肺炎病例的临床疗效和Cmax/MIC未观察到显著差异。尽管有报道称ABK的临床疗效在Cmax/MIC为8或更高时出现,但在本次研究中,所有病例的Cmax/MIC均为8或更高,临床有效率为40.9%。在ABK的Cmax/MIC方面,菌血症病例中临床有效组高于无效组,提示给药方案应使Cmax/MIC至少达到约14或更高。

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