Clinical Research Center for Developmental Therapeutics, Tokushima University Hospital, Tokushima 770-8503,
Department of Pharmacy, Tokushima University Hospital, Tokushima 770-8503, Japan.
Acta Med Okayama. 2020 Aug;74(4):365-370. doi: 10.18926/AMO/60376.
Cystatin C-guided vancomycin (VCM) dosing is useful in critically ill patients. Its usefulness in septic patients with bacterial meningitis remains unknown, as there are no published reports. In this study, we sought to clarify its benefit. Cystatin C was used to guide VCM dosing in a septic bacterial meningitis patient with normal kidney function, according to therapeutic drug monitoring (TDM). Using cystatin C, the Bayesian method-based TDM made optimal VCM dosing possible, and decreased the predicted error (4.85 mg/L) compared to serum creatinine (16.83 mg/L). We concluded TDM of VCM using cystatin C can be considered in sepsis patients with bacterial meningitis with normal kidney function.
胱抑素 C 指导下的万古霉素（VCM）剂量调整在危重症患者中是有用的。其在伴有细菌感染性脑膜炎的脓毒症患者中的作用尚不清楚，因为目前尚无相关报道。在本研究中，我们旨在阐明其益处。根据治疗药物监测（TDM），我们对一名肾功能正常的脓毒症伴细菌性脑膜炎患者使用胱抑素 C 来指导 VCM 的剂量调整。采用胱抑素 C，基于贝叶斯方法的 TDM 实现了最佳的 VCM 剂量调整，与血清肌酐（16.83mg/L）相比，预测误差降低（4.85mg/L）。我们得出结论，对于肾功能正常的伴有细菌感染性脑膜炎的脓毒症患者，可以考虑使用胱抑素 C 进行 VCM 的 TDM。
