影响游离万古霉素浓度及浓度-时间曲线下游离面积目标达成的因素。
Factors affecting free vancomycin concentration and target attainment of free area under the concentration-time curve.
作者信息
Urakami Toshiharu, Oka Yusuke, Matono Takashi, Aoki Yosuke
机构信息
Division of Infectious Disease and Hospital Epidemiology, Saga University Hospital, 5-1-1, Nabeshima, Saga, 849- 8501, Japan.
Department of International Medicine, Faculty of Medicine, Saga University, Saga, Japan.
出版信息
J Pharm Health Care Sci. 2025 Feb 18;11(1):13. doi: 10.1186/s40780-025-00419-4.
BACKGROUND
It has been reported that the protein binding rate of vancomycin (VCM) varies among individual patients. So, the authors investigated relevant factors that may affect free VCM concentration and target attainment of free area under the concentration-time curve (fAUC).
METHODS
Thirty-nine patients were included. Multiple regression analysis was performed to determine the valuable factors in the free VCM concentration, and the target attainment of area under the concentration-time curve (AUC) 400-600 mg・h/L and fAUC200-300 mg・h/L was calculated.
RESULTS
We found total protein was significant covariate for free VCM. Among 18 patients who were investigated for AUC and fAUC estimation, 9 patients (50.0%) and 12 patients (66.7%) reached AUC > 600 mg・h/L, and fAUC > 300 mg・h/L (p = 0.310), respectively.
CONCLUSIONS
Total protein is a significant predictor for free VCM estimation. And the fAUC-guided TDM for VCM TDM may contribute to more strict dosing than the AUC-guided TDM in hyper- or hypo-proteinemic population.
TRIAL REGISTRATION
Retrospectively registered.
背景
据报道，万古霉素（VCM）的蛋白结合率在个体患者中存在差异。因此，作者研究了可能影响游离VCM浓度以及浓度-时间曲线下游离面积（fAUC）达标情况的相关因素。
方法
纳入39例患者。进行多元回归分析以确定游离VCM浓度的相关有价值因素，并计算浓度-时间曲线下面积（AUC）400 - 600mg・h/L和fAUC200 - 300mg・h/L的达标情况。
结果
我们发现总蛋白是游离VCM的显著协变量。在18例接受AUC和fAUC评估的患者中，分别有9例（50.0%）和12例（66.7%）达到AUC > 600mg・h/L和fAUC > 300mg・h/L（p = 0.310）。
结论
总蛋白是游离VCM评估的重要预测指标。对于高蛋白血症或低蛋白血症人群，基于fAUC的万古霉素治疗药物监测（TDM）可能比基于AUC的TDM有助于更严格地给药。
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