Staib A H, Rietbrock N, Neiss A
Dtsch Med Wochenschr. 1985 Apr 26;110(17):680-5. doi: 10.1055/s-2008-1068887.
Serum-theophylline concentration was measured in 486 ambulatory patients from 407 referring practitioners. They had been on maintenance treatment of 350 mg theophylline (Bronchoretard) twice daily. The concentration was within therapeutic range (8 to 20 mg/l) in 53% of patients, while it was below it in 43% and above in 4%. About half the patients receiving this dose would thus need individual adaptation of dosage, guided by clinical findings and serum concentration, in order to achieve optimal use of the drug's prophylactic and therapeutic potential. It is concluded that (1) theophylline dosage based entirely on standard dose will lead to an unacceptably high percentage of under-dosing; (2) schematic consideration of body-weight, sex, age, living habits, and accompanying diseases proved to be unreliable and insufficient for individual dose determination; (3) dose adaptation to individual clinical situations and serum concentration is necessary in theophylline treatment of ambulatory patients and, in the light of present technical facilities, is cost-effective.
对来自407位转诊医生的486名门诊患者测定了血清茶碱浓度。这些患者一直在接受每日两次、每次350毫克茶碱（长效茶堿）的维持治疗。53%的患者血清浓度在治疗范围内（8至20毫克/升），43%低于该范围，4%高于该范围。因此，接受此剂量治疗的患者中约有一半需要根据临床症状和血清浓度进行个体化剂量调整，以实现药物预防和治疗潜力的最佳利用。得出的结论是：（1）完全基于标准剂量的茶碱给药会导致剂量不足的比例高得令人无法接受；（2）对体重、性别、年龄、生活习惯和伴发疾病进行模式化考量，在确定个体剂量时被证明不可靠且不充分；（3）在门诊患者的茶碱治疗中，根据个体临床情况和血清浓度调整剂量是必要的，鉴于目前的技术条件，这具有成本效益。
