文章摘要
陈杏凯,张海霞.蒙特卡罗模拟评价中国成人患者的利奈唑胺给药方案[J].药学与临床研究,2020,28(5):345~348
蒙特卡罗模拟评价中国成人患者的利奈唑胺给药方案
Evaluation of Linezolid Dosing Regimen in Chinese Adult Patients by Monte Carlo Simulation
投稿时间:2020-06-04  修订日期:2020-10-19
DOI:
中文关键词: 利奈唑胺  蒙特卡罗模拟  药动学/药效学
英文关键词: Linezolid  Monte Carlo simulation  Pharmacokinetics/pharmacodynamics
基金项目:
作者单位E-mail
陈杏凯 南京大学医学院附属鼓楼医院 chxkabc@126.com 
张海霞 南京大学医学院附属鼓楼医院 zhx_510@hotmail.com 
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中文摘要:
      目的:应用蒙特卡罗模拟评价中国成人患者的利奈唑胺给药方案。方法:基于先前利奈唑胺的药动学参数以及中国细菌耐药监测报告数据,应用蒙特卡罗模拟计算中国成人患者不同利奈唑胺给药方案的药效学目标达标概率(PTA)和累计反应分数(CFR),从而优化给药方案。结果:对于药效学指标AUC0~24 h/MIC≥100,当MIC为2 mg·L-1时,只有900 mg q12h能够达到目标。对于药效学指标100%f T>MIC,当MIC≤2 mg·L-1时,当前所有给药方案只有600 mg q12h和900 mg q12h能达到PTA≥90%。对于药效学指标AUC0~24 h/MIC≥100的CFR值中,金黄色葡萄球菌和屎肠球菌只有900 mg q12h能够达标,表皮葡萄球菌1200 mg q24h、600 mg q12h 和900 mg q12h能够达标,肺炎链球菌所有方案都能够达标;而对于药效学指标100%f T>MIC的CFR值中,表皮葡萄球菌和肺炎链球菌都是600 mg q12h和900 mg q12h能够达标,金黄色葡萄球菌、粪肠球菌和屎肠球菌只有900 mg q12h能够达标。结论:当前的常见临床给药方案600 mg q12h基本能够达到临床疗效;但需要结合MIC值进行调整。
英文摘要:
      Objective: Monte Carlo simulation was used to evaluate the administration of linezolid in Chinese adult patients. Methods: Based on previous linezolid pharmacokinetic parameters and Chinese bacterial resistance monitoring report data, the Monte Carlo simulation was used to calculate the pharmacodynamic target compliance probability (PTA) and cumulative fraction of response (CFR) of different linezolid administration regimens in Chinese adult patients. Results: For the pharmacodynamic index AUC0-24 h/MIC≥100, when the MIC is 2 mg·L-1, only 900 mg q12h can reach the target. For the pharmacodynamic index 100%fT> MIC, when MIC≤2 mg·L-1, only 600 mg q12h and 900 mg q12h can achieve PTA≥90%. For the CFR value of pharmacodynamic index AUC0-24 h/MIC≥100, Staphylococcus aureus and Enterococcus faecium can meet the standard only by 900 mg q12h, and Staphylococcus epidermidis can meet the standard by 1200 mg q24h, 600 mg q12h and 900 mg q12h, all schemes to Streptococcus pneumoniae can meet the standard; and for the CFR value of pharmacodynamic index 100%fT>MIC, Staphylococcus epidermidis and Streptococcus pneumoniae by 600 mg q12h and 900 mg q12h, Staphylococcus aureus, Enterococcus faecalis and Enterococcus faecium by 900 mg q12h can meet the standard. Conclusion: Current common clinical administration plan of 600 mg q12h can basically achieve clinical efficacy, but some treatments may need to be adjusted and optimizes combining with the MIC values.
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