中国药房2024，Vol.35Issue(16)：2055-2060,6.DOI:10.6039/j.issn.1001-0408.2024.16.21
特殊人群中头孢他啶-阿维巴坦的PK/PD特性及剂量调整研究进展
Research advance in pharmacokinetic/pharmacodynamic characteristics and dose adjustment of ceftazidime-avibactam in special populations
摘要
Abstract
Ceftazidime-avibactam(CAZ/AVI)is a novel β-lactam antibiotic with broad-spectrum antibacterial activity and good tolerability.However,the physiological and pathological differences in special populations[e.g.augmented renal clearance(ARC)patients,undergoing continuous renal replacement therapy(CRRT)patients,neonates and children,obese patients,undergoing extracorporeal membrane oxygenation(ECMO)patients,elderly patients and liver dysfunction patients]may affect the pharmacokinetic(PK)properties of CAZ/AVI,leading to treatment failure.At present,there is currently a lack of corresponding guidelines or consensus on dose adjustment of CAZ/AVI in special populations.This article summarizes the research on PK/pharmacodynamic(PD)characteristics and dose adjustment of CAZ/AVI in special populations and recommends the following dosing regimens:for ARC patients,the recommended dose is 2.5 g,q8 h;for undergoing CRRT patients with infections caused by sensitive strains(i.e.MIC＜4 mg/L)and infections at sites where hydrophilic antibiotics distribute well,a dose of 1.25 g,q8 h may be used;for undergoing CRRT patients with less sensitive strains or sites with poorer drug distribution,a dose of 2.5 g,q8 h or continuous infusion may be considered;for children aged 6 months to＜18 years with normal or mildly impaired renal function,a dose of 62.5 mg/kg,q8 h is infused for 2 h(maximum dose not exceeding 2.5 g per dose);for infants aged 3～6 months with normal or mildly impaired renal function,a dose of 50 mg/kg,q8 h is infused for 2 h;for obese patients,the recommended dose is 2.5 g,q8 h,with therapeutic drug monitoring recommended;undergoing ECMO patients,elderly patients,and those with impaired liver function may also use the recommended dose of 2.5 g,q8 h.关键词
头孢他啶-阿维巴坦/药代动力学/药效动力学/特殊人群/肾功能异常Key words
ceftazidime-avibactam/pharmacokinetic/phar-macodynamic/special populations/renal dysfunction分类
医药卫生引用本文复制引用
李光灿,张萍,郑姣妮,黄兴艳,单雪峰..特殊人群中头孢他啶-阿维巴坦的PK/PD特性及剂量调整研究进展[J].中国药房,2024,35(16):2055-2060,6.基金项目
重庆市科卫联合医学科研项目(No.2021MSXM070) （No.2021MSXM070）
重庆市璧山区社会民生领域科技计划项目(No.BSKJ2023019) （No.BSKJ2023019）
