持续血液透析滤过过程中替加环素清除不佳：使用体外持续血液透析滤过模型的实验
Poor removal of tedizolid during continuous hemodiafiltration: experiments using an in vitro continuous hemodiafiltration model.
作者信息
Yoshikawa Satoshi, Yoshikawa Shinichi, Sato Akira, Matsumoto Tsukasa
机构信息
Faculty of Pharmacy, Iryo Sosei University, 5-5-1 Iino, Chuo-Dai, Iwaki, Fukushima, 970-8551, Japan.
Graduate School of Life Science and Technology, Iryo Sosei University, 5-5-1 Iino, Chuo-Dai, Iwaki, Fukushima, 970-8551, Japan.
出版信息
J Pharm Health Care Sci. 2023 Nov 14;9(1):37. doi: 10.1186/s40780-023-00307-9.
BACKGROUND
Tedizolid is an oxazolidinone anti-MRSA drug with included in the National Health Insurance Drug Price List in 2018. The effect of hemodialysis on tedizolid phosphate concentrations has been reported; pre-dialysis concentrations decreased by 10% compared to post- dialysis concentrations. However, the material of the dialysis membrane remains unknown. In addition, there have been no reports on the effects of continuous hemodiafiltration. In this study, we investigated the effects of continuous hemodiafiltration on tedizolid using two types of dialysis membranes made of different materials.
METHODS
The adsorption of tedizolid, linezolid, and vancomycin to two different dialysis membranes was investigated, and the clearance of each drug was calculated by experiments using an in vitro continuous hemodiafiltration model.
RESULTS
The adsorption of tedizolid, linezolid, and vancomycin on the dialysis membranes was examined, and no adsorption was observed. Experimental results from the continuous hemodiafiltration model showed that linezolid and vancomycin concentrations decreased over time: after two hours, the respective decreases were 26.48 ± 7.14% and 28.51 ± 2.32% for polysulfone membranes, respectively. The decrease was 23.57 ± 4.95% and 28.73 ± 5.13% for the polymethylmethacrylate membranes, respectively. These results suggested that linezolid and vancomycin were eliminated by continuous hemodiafiltration. In contrast, tedizolid phosphate and tedizolid concentrations decreased slightly in the polysulfone and polymethylmethacrylate membranes. The decrease in concentrations were 2.10 ± 0.77% and 2.97 ± 0.60% for the polysulfone membranes, respectively. For the polymethylmethacrylate membranes, the decrease in concentration were 2.01 ± 0.88% and 1.73 ± 0.27%, respectively.
CONCLUSION
These results suggested that tedizolid should not be considered for dose control during continuous hemodiafiltration.
背景
特地唑胺是一种恶唑烷酮类抗耐甲氧西林金黄色葡萄球菌（MRSA）药物，于2018年被列入国家医保药品价格目录。已有关于血液透析对特地唑胺磷酸盐浓度影响的报道；透析前浓度与透析后浓度相比降低了10%。然而，透析膜的材料仍然未知。此外，尚无关于连续性血液滤过影响的报道。在本研究中，我们使用两种不同材料制成的透析膜研究了连续性血液滤过对特地唑胺的影响。
方法
研究了特地唑胺、利奈唑胺和万古霉素对两种不同透析膜的吸附情况，并通过体外连续性血液滤过模型实验计算了每种药物的清除率。
结果
检测了特地唑胺、利奈唑胺和万古霉素在透析膜上的吸附情况，未观察到吸附现象。连续性血液滤过模型的实验结果表明，利奈唑胺和万古霉素的浓度随时间降低：两小时后，聚砜膜的利奈唑胺和万古霉素浓度分别降低了26.48±7.14%和28.51±2.32%。聚甲基丙烯酸甲酯膜的浓度分别降低了23.57±4.95%和28.73±5.13%。这些结果表明利奈唑胺和万古霉素可通过连续性血液滤过清除。相比之下，特地唑胺磷酸盐和特地唑胺在聚砜膜和聚甲基丙烯酸甲酯膜中的浓度略有降低。聚砜膜中浓度的降低分别为2.10±0.77%和2.97±0.60%。聚甲基丙烯酸甲酯膜中浓度的降低分别为2.01±0.8
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