三唑类治疗药物监测的可及性和时间对其的影响。
Impact of Triazole Therapeutic Drug Monitoring Availability and Timing.
机构信息
Department of Pharmacy, University of Wisconsin Health, Madison, Wisconsin, USA.
Department of Medicine, Division of Infectious Diseases, University of Wisconsin, Madison, Wisconsin, USA.
出版信息
Antimicrob Agents Chemother. 2019 Sep 23;63(10). doi: 10.1128/AAC.01245-19. Print 2019 Oct.
Abstract
Therapeutic drug monitoring (TDM) is an established strategy to optimize antifungal therapy with certain triazoles. While established relationships exist between concentration and safety or efficacy, the impact of TDM timing on outcomes is unknown. We report clinical outcomes, including antifungal exposure and mortality, in patients receiving institutional versus reference laboratory TDM. The availability of in-house triazole assays reduced the time to drug concentration result (12 versus 68 h; < 0.001) and time to achieve therapeutic serum concentrations (10 versus 31 days; < 0.001). Subtherapeutic concentrations were associated with higher patient mortality (32% versus 13.3%; = 0.036).
摘要
治疗药物监测（TDM）是优化某些三唑类抗真菌治疗的既定策略。虽然浓度与安全性或疗效之间存在既定关系，但 TDM 时间对结果的影响尚不清楚。我们报告了接受机构与参考实验室 TDM 的患者的临床结果，包括抗真菌药物暴露和死亡率。内部三唑类药物检测的可用性缩短了药物浓度结果的时间（12 小时与 68 小时；<0.001）和达到治疗血清浓度的时间（10 天与 31 天；<0.001）。治疗浓度与更高的患者死亡率相关（32%与 13.3%；=0.036）。
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