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针对心内膜炎患者和肾衰竭患者耐甲氧西林金黄色葡萄球菌感染的替考拉宁最佳给药方案。

Optimal teicoplanin dosage regimens for methicillin-resistant Staphylococcus aureus infections in endocarditis patients and renal failure patients.

作者信息

Li Na, Zhu Liqin, Xu Gaoqi, Ge Tingyue, Qi Fang, Li Mengxue

机构信息

a Department of Clinical Pharmacy , Tianjin Medical University , Tianjin , China.

b Department of Pharmacy , Tianjin First Central Hospital , Tianjin , China.

出版信息

J Chemother. 2017 Dec;29(6):358-364. doi: 10.1080/1120009X.2017.1334031. Epub 2017 Jun 6.

Abstract

This study aimed to assess whether traditional initial loading and maintenance doses of teicoplanin were appropriate in endocarditis and renal failure patients with methicillin-resistant Staphylococcus aureus (MRSA) infections and to recommend optimal dosage regimens. Pharmacokinetic parameters and physicochemical properties of teicoplanin were performed to develop pharmacokinetic models using GastroPlus. Concentration-time curves of teicoplanin in endocarditis and renal failure patients with MRSA infections were simulated by changing clearance (CL) and volume of distribution of the central compartment (V). Different teicoplanin dosage regimens were assessed according to the target trough concentration, and optimal teicoplanin dosage regimens were recommended. Dosage regimen of four teicoplanin doses of 6 mg/kg q12 h followed by 6 mg/kg qd is recommended for renal failure patients infected by MRSA. And optimal dosage regimen is five teicoplanin doses of 15 mg/kg q12 h followed by doses of 12 mg/kg qd for endocarditis patients infected by MRSA.

摘要

本研究旨在评估替考拉宁传统的初始负荷剂量和维持剂量对于耐甲氧西林金黄色葡萄球菌(MRSA)感染的心内膜炎和肾衰竭患者是否合适,并推荐最佳给药方案。利用 GastroPlus 软件对替考拉宁的药代动力学参数和理化性质进行分析,以建立药代动力学模型。通过改变清除率(CL)和中央室分布容积(V),模拟替考拉宁在 MRSA 感染的心内膜炎和肾衰竭患者体内的浓度-时间曲线。根据目标谷浓度评估不同的替考拉宁给药方案,并推荐最佳的替考拉宁给药方案。对于 MRSA 感染的肾衰竭患者,推荐采用 6 mg/kg 每 12 小时一次,随后 6 mg/kg 每日一次的四剂替考拉宁给药方案。而对于 MRSA 感染的心内膜炎患者,最佳给药方案是 15 mg/kg 每 12 小时一次的五剂替考拉宁,随后 12 mg/kg 每日一次。

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