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在囊性纤维化患者中使用连续输注头孢他啶-他唑巴坦并进行治疗药物监测。

Use of continuous infusion ceftolozane-tazobactam with therapeutic drug monitoring in a patient with cystic fibrosis.

机构信息

University of South Carolina College of Pharmacy, Columbia, SC.

Department of Pharmacy, Memorial Hospital West, Pembroke Pines, FL.

出版信息

Am J Health Syst Pharm. 2019 Apr 8;76(8):501-504. doi: 10.1093/ajhp/zxz011.

Abstract

PURPOSE

The safe and effective use of ceftolozane-tazobactam delivered via continuous infusion in a cystic fibrosis (CF) patient with reduced body weight and presumed augmented renal clearance is reported.

SUMMARY

A 30-year-old woman with CF was admitted for acute pulmonary exacerbations with positive respiratory cultures for Pseudomonas aeruginosa and extended-spectrum β-lactamase-producing Escherichia coli. Susceptibility testing confirmed multidrug resistance, and the patient was transitioned to ceftolozane-tazobactam for definitive therapy. A novel strategy of administering ceftolozane-tazobactam 6 g by continuous i.v. infusion over 24 hours was initiated during hospitalization and continued at discharge for a total of 10 days. Therapeutic drug monitoring over the first 36 hours of the continuous infusion confirmed adequate exposure. The patient had clinical resolution with return to baseline of pulmonary function tests and no noted adverse drug events.

CONCLUSION

A continuous infusion regimen of ceftolozane-tazobactam was successfully used in a CF patient with augmented renal clearance.

摘要

目的

报告了一例体重减轻和推测肾清除率增强的囊性纤维化(CF)患者,通过连续输注给予头孢他唑巴坦-他唑巴坦,实现了安全有效的使用。

摘要

一名 30 岁的女性 CF 患者因急性肺部恶化入院,其呼吸道培养出铜绿假单胞菌和产超广谱β-内酰胺酶的大肠杆菌呈阳性。药敏试验证实为多种药物耐药,患者转为头孢他唑巴坦-他唑巴坦进行确定性治疗。在住院期间开始采用新型策略,即通过静脉滴注 24 小时内输注头孢他唑巴坦-他唑巴坦 6 g,在出院时继续使用,总共使用 10 天。连续输注的前 36 小时内的治疗药物监测证实了足够的暴露量。该患者的临床症状得到缓解,肺功能测试恢复到基线水平,未观察到药物不良反应。

结论

在 CF 患者中,增强的肾清除率可成功使用头孢他唑巴坦-他唑巴坦的连续输注方案。

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