通过贝叶斯算法进行万古霉素个体化治疗的实用性:对危重病人进行的为期 5 年的研究。

Personalized medicine Pub Date : 2024-01-01 Epub Date: 2024-06-28 DOI:10.1080/17410541.2024.2365616
Salvador Cabrera Figueroa, Diego Salazar Pincheira, Claudio Bustos Navarrete, Juan Hermosilla Panés, Sergio Mella Montecinos, Leonila Ferreira Cabrera
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引用次数: 0

摘要

目的:比较两种万古霉素给药策略在耐甲氧西林金黄色葡萄球菌(MRSA)感染危重患者中的应用,考虑给药方案的异质性及其对毒性和疗效的影响。材料与方法:对两个患者队列(标准剂量与贝叶斯算法剂量)进行纵向回顾性观察研究。结果贝叶斯算法组接受的剂量大大增加,且剂量明显不均,但无肾毒性。贝叶斯算法组的 CRP 和 PCT 下降速度更快(p = 0.045 和 0.0009)。结论在万古霉素剂量个体化中应用贝叶斯算法,可以使用比标准方案高得多的剂量,从而在无肾毒性的情况下加快临床反应。
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Usefulness of vancomycin treatment individualization via Bayesian algorithms: a 5-year study in critical patients.

Aim: Compare two vancomycin dosing strategies in critical patients with methicillin-resistant Staphylococcus aureus (MRSA) infections, considering the heterogeneity of the dosing regimens administered and their implications for toxicity and efficacy. Materials & methods: Longitudinal retrospective observational study in two patient cohorts (standard dosing vs dosing via Bayesian algorithms). Results: The group of Bayesian algorithms received substantially higher and significantly heterogeneous doses, with an absence of nephrotoxicity. The speed of decrease observed in CRP and PCT was greater for the Bayesian strategy (p = 0.045 and 0.0009, respectively). Conclusion: Applying Bayesian algorithms to vancomycin dosage individualization allows for administering much higher doses than with standard regimens, facilitating a quicker clinical response in the absence of nephrotoxicity.

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