OBJECTIVE To investigate serum linezolid concentration in critically infectious patients in ICU. METHODS Linezolid concentrations in serum were monitored in seven critical patients by HPLC. RESULTS 34 linezolid serum samples were analyzed in critical patients， including 5 patients undergoing continuous venovenous haemofiltration (CVVH). Linezolid serum concentrations changed significantly in the seven patients during the treatment， with the average trough concentration range of 1.27-7.59 mg·L-1. The minimum inhibitory concentration was 2 mg·L-1. The linezolid trough concentration (1.27 mg·L-1) in one patient was below the minimum inhibitory concentration， and another patient showed unexpected trough concentration fluctuation (nearly 10-fold). The clinical outcome of one patients， although his trough concentrations (7.59 mg·L-1) were above minimum inhibitory concentrations， was failure. CONCLUSION Linezolid serum concentrations in critically ill patients shows significant variability， and serum drug concentration should be monitored in these kinds patients in order to decide individual dosage regimen of linezolid in clinical practice.
DONG Hi-yn;DONG Y-lin;WNG Xue;YNG Hu;LI Ho;LIU Jun-jun.
Therapy Drug Monitoring of Linezolid in Serum of Critically Ill Patients[J]. Chinese Pharmaceutical Journal, 2010, 45(16): 1255-1258
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参考文献
[1] Centers for Disease Control and Prevention. Guidelines for the prevention of intravascular catheter-related infections [J]. Morb Mortal Wkly Rep， 2002， 51(10)：1-29. [2] JONES R N， FRITSCHE T R， SADER H S， et al. ZyvoxR Annual Appraisal of Potency and Spectrum Program Results for 2006：an activity and spectrum analysis of linezolid using clinical isolates from 16 countries [J]. Diagn Microbiol Infect Dis， 2007， 59(2)：199-209. [3] RAYNER C R， FORREST A， MEAGHER A K， et al. Clinical pharmacodynamics of linezolid in seriously ill patients treated in a compassionate use programme [J]. Clin Pharmacokinet， 2003， 42(15)：1411-1423. [4] WHITEHOUSE T， CEPEDA J A， SHULMAN R， et al. Pharmacokinetic studies of linezolid and teicoplanin in the critically ill [J]. J Antimicrob Chemother， 2005， 55(3)：333-340. [5] CORNELIA B， NELE P， PEJMAN D， et al. Pharmacokinetics of unbound linezolid in plasma and tissue interstitium of critically ill patients after multiple dosing using microdialysis [J]. Antimicrob Agents Chemother， 2006， 50(7)：2455-2463. [6] KEITH M， O'NEILL A J， WILCOX M H， et al. Delayed development of linezolid resistance in Staphylococcus aureus following exposure to low levels of antimicrobial agents [J]. Antimicrob Agents Chemother， 2008， 52(6)：1940-1944. [7] RUIZ M E， GUERRERO I C， TUAZON C U. Endocarditis caused by methicillin-resistant Staphylococcus aureus：treatment failure with linezolid [J]. Clin Infect Dis， 2003， 36(5)：675-676. [8] AUCKLAND C， TEARE L， COOKE F， et al. Linezolid-resistant enterococci：report of the first isolates in the United Kingdom [J]. J Antimicrob Chemother， 2005， 55(3)：333-340. [9] MEYER B， KORNEK G V， NIKFARDJAM M， et al. Multiple-dose pharmacokinetics of linezolid during continuous venovenous haemofiltration [J]. J Antimicrob Chemother， 2005， 56(1)：172-179.
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