庆大霉素是否在治疗开始时就以最佳剂量给予患者?

M. Göböová, I. Vano, V. Kissova, Tomas Fazekas, M. Kuzelova
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引用次数: 0

摘要

摘要简介医生选择的庆大霉素剂量通常不考虑任何药代动力学参数。目的分析治疗开始时未调整庆大霉素剂量的患者(第一组)和治疗开始时调整庆大霉素剂量(第二组)的庆大霉素治疗药物监测结果。方法根据庆大霉素水平的实验室检查要求,获取患者的基本资料。我们使用FPIA方法测量了本工作中提到的所有庆大霉素浓度。结果监测组包括379名4年内住院的患者。我们将被监测组分为两组。第一组由治疗开始时未调整庆大霉素剂量的患者组成,第二组由临床药剂师在治疗开始时调整了庆大霉素剂量的病人组成。此外,每组患者根据体重指数(BMI)进行分组。在第一组患者中,低比例的患者同时达到最佳水平(谷值、峰值)。在BMI>25m2/kg的患者中,此类病例仅占17%,BMI≤25m2/kg患者仅占18.8%。在第二组中,肥胖患者、超重患者和体重正常的患者的所有谷值和峰值水平都在最佳治疗范围内(p<0.001),这是成功的抗感染治疗的先决条件。水平的治疗监测允许给予足够剂量的庆大霉素,而不用担心任何不良影响。
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Is gentamicin administered to individual patients in optimal doses already at the beginning of therapy?
Abstract Introduction A gentamicin dose, which the physicians select, frequently does not take any pharmacokinetic parameters into consideration. Aim To analyse the results of therapeutic drug monitoring (TDM) of gentamicin for those patients who have not had the gentamicin dose adjusted at the beginning of therapy (first group) and for those patients who had the gentamicin dose adjusted at the beginning of therapy (second group). Methods We acquired the basic data about patients from the requests for laboratory examination of levels of gentamicin. We measured all the gentamicin concentrations mentioned in this work using the FPIA method. Results The monitored set included 379 hospitalized patients during a 4-year period. We divided the monitored set into 2 groups. First group was composed of patients without dose adjustment of gentamicin at the beginning of therapy, and the second group was composed of patients with dose adjustment of gentamicin by the clinical pharmacist at the beginning of therapy. In addition, the patients in each group were divided according to the body mass index (BMI). In the first group of patients, a low percentage of patients had both optimal levels (trough, peak levels). As for patients with BMI > 25 m2/kg, there were only 17 % such cases, and the patients with BMI ≤ 25 m2/kg were only 18.8 %. In the second group, the patients had all trough and peak levels in optimal therapeutic range at obese patients, overweight patients and also at patients with normal weight (p < 0.001). Conclusion Adjustment of dosage regimens immediately at the beginning of therapy will provide for administering sufficient doses of antibiotics at the beginning of therapy, which is a pre-condition for a successful anti-infective therapy. Therapeutic monitoring of levels allows for administration of sufficient dose of gentamicin without fear of any undesirable effects.
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来源期刊
European Pharmaceutical Journal
European Pharmaceutical Journal Pharmacology, Toxicology and Pharmaceutics-Pharmacology, Toxicology and Pharmaceutics (all)
CiteScore
0.60
自引率
0.00%
发文量
16
期刊介绍: European Pharmaceutical Journal publishes only original articles not previously published and articles that are not being considered or have not been submitted for publication elsewhere. If parts of the results have been published as conference abstract or elsewhere, it should be stated in references. The ethical standards of the Helsinki-Tokio Declaration should be kept. This should be mentioned in the Methods of manuscript. Reviews are published only on request. Authors, whose submitted research work was performed with the support of a company, should indicate this in Conflict of Interest.
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