中国临床药学杂志2025，Vol.34Issue(4)：272-277,6.DOI:10.19577/j.1007-4406.2025.04.006
利奈唑胺在重症急性胰腺炎伴胆道感染患者血浆和胆汁中的PK/PD研究
PK/PD study of linezolid in plasma and bile in patients with severe acute pancreatitis associated with biliary tract infection
摘要
Abstract
AIM To analyze the pharmacokinetic/pharmacodynamics(PK/PD)of linezolid in plasma and bile using therapeutic drug monitoring(TDM)data from patients with severe acute pancreatitis(SAP)associated with biliary tract infection,to provide theoretical support for the rational clinical application of linezolid.METHODS A retrospective analysis was conducted on patients with SAP complicated by biliary tract infection who were admitted to the EICU and received linezolid therapy with TDM from January 2018 to June 2023.The study collected demographic characteristics,laboratory parameters upon admission,linezolid dosing regimens(dosage,administration routes,and frequency),TDM results(concentration-time profiles in plasma and bile),clinical outcomes,microbiological test reports,etc.According to the administration route,the selected patients were divided into the gastric tube administration group and intravenous injection group,with 5 patients in each group.Pharmacokinetics(PK)parameters were calculated using SAS 2.0 software with intergroup comparisons performed.The microbiological culture specimens were also examined to calculate the minimum inhibitory concentration(MIC).PK/PD parameters(AUC0-24/MIC)were calculated based on the PK parameters AUC0-24 for linezolid in plasma and bile and its mean MIC for Staphylococcus aureus,Enterococcus faecalis,and Enterococcus faecium.RESULTS The concentration of linezolid in bile was much higher than plasma,and the distribution of linezolid in bile(AUC0-24)in intravenous and gastric patients was 194.6％and 274.3％of plasma,respectively.The MIC of linezolid for Staphylococcus aureus,Enterococcus faecalis and Enterococcus faecium were 0.79,1.21 and 1.09 μg·mL-1,respectively.In the intravenous group,the AUC0-24/MIC ratios of linezolid in plasma against Staphylococcus aureus,Enterococcus faecalis,and Enterococcus faecium were 135.4,88.4,and 98.2,respectively;corresponding values in bile were 263.5,172.1,and 191.0.In the intragastric tube group,plasma AUC0-24/MIC ratios were 56.2,36.7,and 40.7 for the 3 pathogens,while bile concentrations reached 154.2,100.7,and 111.7,respectively.For patients with biliary tract infections,both groups achieved complete microbiological eradication and 100％survival within 30 days.CONCLUSION Linezolid represents a clinically appropriate antibiotic choice for SAP patients with biliary infections,demonstrating potent activity against Staphylococcus aureus,Enterococcus faecalis,and Enterococcus faecium.For patients requiring intragastric tube administration,TDM should be implemented to optimize dosing regimens,mitigate the development of antimicrobial resistance,and ensure treatment safety.关键词
利奈唑胺/药动学/药效学/重症急性胰腺炎/胆道感染Key words
linezolid/pharmacokinetics/pharmacodynamics/severe acute pancreatitis/biliary tract infection分类
药学引用本文复制引用
石颖,高永跃,陈冰,卞晓岚,王义辉,旦增达瓦,章俊,毛恩强,何娟..利奈唑胺在重症急性胰腺炎伴胆道感染患者血浆和胆汁中的PK/PD研究[J].中国临床药学杂志,2025,34(4):272-277,6.基金项目
中华国际医学交流基金会资助项目(编号RC20200120) （编号RC20200120）
