Setiawan Eko, Cotta Menino Osbert, Roberts Jason A, Abdul-Aziz Mohd Hafiz
University of Queensland Centre for Clinical Research [UQCCR], Faculty of Medicine, The University of Queensland, Brisbane 4006, Australia.
Department of Clinical and Community Pharmacy, Center for Medicines Information and Pharmaceutical Care [CMIPC], Faculty of Pharmacy, University of Surabaya, Surabaya 60293, Indonesia.
Antibiotics (Basel). 2023 Apr 23;12(5):803. doi: 10.3390/antibiotics12050803.
While the relevance of inter-ethnic differences to the pharmacokinetic variabilities of antimicrobials has been reported in studies recruiting healthy subjects, differences in antimicrobial pharmacokinetics between Asian and non-Asian patients with severe pathologic conditions require further investigation. For the purpose of describing the potential differences in antimicrobial pharmacokinetics between Asian and non-Asian populations, a systematic review was performed using six journal databases and six theses/dissertation databases (PROSPERO record CRD42018090054). The pharmacokinetic data of healthy volunteers and non-critically ill and critically ill patients were reviewed. Thirty studies on meropenem, imipenem, doripenem, linezolid, and vancomycin were included in the final descriptive summaries. In studies recruiting hospitalised patients, inconsistent differences in the volume of distribution (V) and drug clearance (CL) of the studied antimicrobials between Asian and non-Asian patients were observed. Additionally, factors other than ethnicity, such as demographic (e.g., age) or clinical (e.g., sepsis) factors, were suggested to better characterise these pharmacokinetic differences. Inconsistent differences in pharmacokinetic parameters between Asian and non-Asian subjects/patients may suggest that ethnicity is not an important predictor to characterise interindividual pharmacokinetic differences between meropenem, imipenem, doripenem, linezolid, and vancomycin. Therefore, the dosing regimens of these antimicrobials should be adjusted according to patients' demographic or clinical characteristics that can better describe pharmacokinetic differences.
虽然在招募健康受试者的研究中已报道了种族间差异与抗菌药物药代动力学变异性的相关性，但亚洲和非亚洲患有严重病理状况的患者之间抗菌药物药代动力学的差异仍需进一步研究。为了描述亚洲和非亚洲人群之间抗菌药物药代动力学的潜在差异，我们使用六个期刊数据库和六个论文/学位论文数据库进行了系统综述（PROSPERO记录CRD42018090054）。我们对健康志愿者以及非危重症和危重症患者的药代动力学数据进行了综述。最终的描述性总结纳入了30项关于美罗培南、亚胺培南、多利培南、利奈唑胺和万古霉素的研究。在招募住院患者的研究中，观察到亚洲和非亚洲患者之间所研究抗菌药物的分布容积（V）和药物清除率（CL）存在不一致的差异。此外，有人建议除种族外的其他因素，如人口统计学因素（如年龄）或临床因素（如脓毒症），能更好地描述这些药代动力学差异。亚洲和非亚洲受试者/患者之间药代动力学参数的不一致差异可能表明，种族不是表征美罗培南、亚胺培南、多利培南、利奈唑胺和万古霉素个体间药代动力学差异的重要预测因素。因此，这些抗菌药物的给药方案应根据能更好描述药代动力学差异的患者人口统计学或临床特征进行调整。
