医药导报2024，Vol.43Issue(1)：122-126,5.DOI:10.3870/j.issn.1004-0781.2024.01.019
肾功能亢进患者美罗培南药动学/药效学达标情况及谷浓度影响因素
Analysis of Pharmacokinetics/Pharmacodynamics Compliance and Influencing Factors of Meropenem Concentration in Patients with Augmented Renal Clearance
摘要
Abstract
Objective To explore the pharmacokinetics/pharmacodynamics(PK/PD)parameters and influencing factors in patients with augmented renal clearance(ARC)to provide the basis for the rational use of meropenem.Methods Using the method of retrospective study,the patients with increased renal clearance who used meropenem monitored the concentration from January 2018 to December 2021.The PK/PD parameters of meropenem were analyzed,and multiple linear retrospective analyses discussed the influencing factors of meropenem valley concentration.Results A total of 58 patients were included in the study,and the trough concentration was 1.35[0.23,1.86]μg·mL-1,taking 100%fT＞MIC as PK/PD target value,the compliance rate was 20.69%.The compliance rate of daily dose＜3 g·d-1 was 8.70%,and≥3 g·d-1 was 31.43%,the difference was statistically significant.With MIC of 0.5,1,2,4,and 8 μg·mL-1,PK/PD compliance rates were 62.07%,48.28%,20.69%,8.62%and 0.Respectively.Multiple linear retrospective analyses showed that dose was an independent factor affecting meropenem valley concentration.Conclusion The PK/PD compliance rate of meropenem in patients with augmented renal clearance is low,even if MIC≤0.5 μg·mL-1,the routine dose is difficult to achieve the ideal PK/PD,so the clinical should recognize ARC and perform TDM as soon as possible,and use TDM to guide the medication regimen of meropenem for ARC patients.关键词
美罗培南/肾功能亢进/血药浓度/药动学/药效学Key words
Meropenem/Augmented renal clearance/Blood concentration/Pharmacokinetics/Pharmacodynamics分类
医药卫生引用本文复制引用
陈沈珏,李昕,伍敏益,刘丽华,何鑫,李美云..肾功能亢进患者美罗培南药动学/药效学达标情况及谷浓度影响因素[J].医药导报,2024,43(1):122-126,5.基金项目
湖南省感染性疾病合理用药临床医疗技术示范基地基金资助项目(2016SK4008) （2016SK4008）
湖南省卫生健康委课题(202113011891). （202113011891）
