Yamashina Takuya, Tsuruyama Moeko, Odawara Miki, Tsuruta Minako, Miyata Hirochika, Kozono Aki, Tsuji Yasuhiro, Miyoshi Takanori, Kawamata Yosei, Hiraki Yoichi
Department of Pharmacy, National Hospital Organization Beppu Medical Center, 1473 Uchikamado, Beppu City, Oita 874-0011, Japan.
Department of Pharmacy, National Hospital Organization Beppu Medical Center, 1473 Uchikamado, Beppu City, Oita 874-0011, Japan.
J Infect Chemother. 2017 Oct;23(10):709-712. doi: 10.1016/j.jiac.2017.03.013. Epub 2017 Apr 10.
The pharmacokinetics of linezolid clearance (CL) during continuous hemodiafiltration (CHDF) has not been comprehensively analyzed. Here, we examined CL by CHDF in a patient with septic shock and disseminated intravascular coagulation due to methicillin-resistant Staphylococcus aureus. The extraction ratio of LZD by CHDF was 22.6%, and the protein-binding rate was 17.9% ± 7.7%. In addition, it was determined that the calculated total body clearance of LZD was 30.2 mL/min, plasma elimination half-life was 8.66 h, and the CL by the dialyzer used for CHDF was 23.0 mL/min. From the obtained pharmacokinetics, the CL of patients continuing CHDF was estimated to be approximately half of the reported CL for healthy subjects. In addition, the LZD concentration of the sepsis patient who underwent CHDF remained higher than the minimum inhibitory concentration and was similar to the LZD concentrations reported in normal renal function patients. Although further studies are warranted, when LZD is administered to patients treated with CHDF, the present findings suggest that dose regulation is not required.
连续性血液透析滤过（CHDF）期间利奈唑胺清除率（CL）的药代动力学尚未得到全面分析。在此，我们对一名因耐甲氧西林金黄色葡萄球菌导致感染性休克和弥散性血管内凝血的患者进行了CHDF对CL的研究。CHDF对利奈唑胺的提取率为22.6%，蛋白结合率为17.9%±7.7%。此外，经计算确定利奈唑胺的总体清除率为30.2 mL/min，血浆消除半衰期为8.66小时，用于CHDF的透析器对利奈唑胺的清除率为23.0 mL/min。根据所获得的药代动力学数据，持续进行CHDF的患者的CL估计约为健康受试者报告CL的一半。此外，接受CHDF的脓毒症患者的利奈唑胺浓度仍高于最低抑菌浓度，且与肾功能正常患者报告的利奈唑胺浓度相似。尽管有必要进行进一步研究，但当对接受CHDF治疗的患者使用利奈唑胺时，目前的研究结果表明无需调整剂量。
