Crit Care Med:PICU中β内酰胺治疗药物管理与患儿结局

2018-03-12 吴星 环球医学资讯

2018年2月,发表在《Crit Care Med》的一项由美国科学家进行的研究,考察了PICU中β内酰胺治疗药物的管理情况,以及其与重症儿童结局的相关性

2018年2月,发表在《Crit Care Med》的一项由美国科学家进行的研究,考察了PICU中β内酰胺治疗药物的管理情况,以及其与重症儿童结局的相关性。

目的:考察当前重症儿童β内酰胺抗感染剂量推荐是否能实现最大抗菌活性相关浓度。次要目的是描述β内酰胺治疗药物管理相关的微生物和临床结局。

设计:电子医疗记录评价。

地点:美国费城一家拥有189张床位的独立三级儿童护理教学医院。

受试者:2014年9月1日至2017年5月31日,因为脓毒症入住PICU,且采用常规β内酰胺治疗药物管理,使用体外支持治疗,包括体外膜肺氧合或持续肾脏替代疗法的患者。

干预:无。

测量指标和主要结果:对总队列82例患者和感染队列23例患者的248个样本进行治疗药物管理分析。中位年龄为1岁(范围,4天至18岁),平均体重为19.7?±?22.3?kg(范围,2.7至116?kg)。23例患者(28%)的正常无菌部位出现病原菌的生长。82例患者中有78例(95%)患者未达到抗感染治疗浓度,且未达到主要的药效终点。感染队列的所有患者实现了微生物应答,23例患者中有22例患者(95.7%)实现积极临床应答。

结论:总之,95%的患者的药物浓度低于抗感染治疗浓度,且没有达到目前儿科用药推荐的必要药效学暴露。所有患者实现了微生物应答,95.7%实现了积极β内酰胺治疗药物管理的临床应答。这些数据表明,β内酰胺治疗药物管理是优化抗菌药效学和药动学暴露的一种潜在有价值的干预。此外,这些数据也表明,需要更多特定儿童人群的研究,在更大的儿童患者队列中,评价β内酰胺治疗药物管理相关临床结局。

原始出处:

Cies JJ,et al.β-lactam Therapeutic Drug Management in the PICU.Crit Care Med. 2018 Feb;46(2):272-279.

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    2018-12-11 lqvr
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    2018-03-12 1e1b8538m79(暂无匿称)

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