Martin C, Mallet M N, Saux P, Bruguerolle B, Herat V, Gouin F
Department of Anaesthesia and Intensive Care, Sainte-Marguerite Hospital, Marseille, France.
J Antimicrob Chemother. 1988 Oct;22(4):505-11. doi: 10.1093/jac/22.4.505.
The ability of a simple rule of thumb, based on creatinine clearance, to predict tobramycin serum concentrations was evaluated in mechanically ventilated patients. They were given tobramycin intravenously over 30 min at 8 h intervals. Creatinine clearance was estimated from the formula developed by Cockcroft & Gault (1976, Nephron 16, 31-41) or was calculated after urine collection for 24 h. The loading dose was 1.5 mg/kg and then dose adjustments were performed on a daily basis. Patients were studied on day 1 and day 3. Mean values of peak and trough levels were within the therapeutic range, but individual values were outside the therapeutic range in 30% to 70% of patients on both day 1 and day 3, most of the patients having subtherapeutic serum concentrations. This was mainly related to the high volume of distribution of tobramycin calculated in these patients. These results further emphasize the need to monitor serum concentrations and to use an individual pharmacokinetic method to make dose adjustment.
在机械通气患者中评估了一种基于肌酐清除率的简单经验法则预测妥布霉素血清浓度的能力。他们每8小时静脉注射妥布霉素30分钟。肌酐清除率根据Cockcroft和Gault（1976年，《肾单位》16卷，31 - 41页）制定的公式估算，或在收集24小时尿液后计算得出。负荷剂量为1.5mg/kg，然后每天进行剂量调整。在第1天和第3天对患者进行研究。峰浓度和谷浓度的平均值在治疗范围内，但在第1天和第3天，30%至70%的患者个体值超出治疗范围，大多数患者血清浓度低于治疗水平。这主要与这些患者中计算出的妥布霉素高分布容积有关。这些结果进一步强调了监测血清浓度并使用个体药代动力学方法进行剂量调整的必要性。
