替考拉宁治疗药物监测横断面调查对比研究

于宁, 张相林, 陈超阳, 郭冬杰, 张镭, 刘亚欧, 周颖, 崔一民

中国药学杂志 ›› 2022, Vol. 57 ›› Issue (11) : 950-954.

PDF(936 KB)
PDF(936 KB)
中国药学杂志 ›› 2022, Vol. 57 ›› Issue (11) : 950-954. DOI: 10.11669/cpj.2022.11.012
论著

替考拉宁治疗药物监测横断面调查对比研究

  • 于宁1,2, 张相林2, 陈超阳3, 郭冬杰2, 张镭2, 刘亚欧3, 周颖1,3, 崔一民1,3*
作者信息 +

Comparative Research of Cross-sectional Investigation of Drug Monitoring in Treatment of Teicoplanin

  • YU Ning1,2, ZHANG Xiang-lin2, CHEN Chao-yang3, GUO Dong-jie2, ZHANG Lei2, LIU Ya-ou3, ZHOU Ying1,3, CUI Yi-min1,3*
Author information +
文章历史 +

摘要

目的 探讨开展替考拉宁治疗药物监测(therapeutic drug monitoring,TDM)的必要性以及中日友好医院在该方面两次调查结果对比,探索临床合理使用替考拉宁的进展情况。方法 采用横断面调查的方法,收集2020年1月1日至2020年12月31日间中日友好医院73例接受替考拉宁治疗药物监测的住院患者的临床资料,对111例次血药浓度监测数据进行统计分析,并与2018年调查结果进行对比研究。结果 替考拉宁血药谷浓度中位数为17.31(12.04,29.59)mg·L-1(2020年)vs (7.77±4.31) mg·L-1(2018年);血药谷浓度>10 mg·L-1的89例(80.18%)(2020年)vs 11例(27.50%)(2018年);血药谷浓度>20 mg·L-1的46例(41.44%)(2020年)vs 1例(2.50%)(2018年);95.71%(2020年)vs 53.01%(2018年)的患者给予了负荷剂量(P<0.000 1),采用方案最多的是600 mg q12 h(57.14%)(2020年)vs 400 mg q12 h(63.92%)(2018年),维持剂量采用最多的是600 mg qd(28.77%)(2020年)vs 400 mg qd(32.24%)(2018年);2020年血药谷浓度在正常范围(10~20 mg·L-1)内的患者在使用替考拉宁后,平均白细胞计数、中性粒细胞百分比及降钙素原(procalcitonin,PCT)水平较使用前显著下降;总体治疗有效率93.15%(2020年)vs 50.82%(2018年)显著改善(P<0.000 1)。结论 与2018年调查对比研究可得,替考拉宁平均用药剂量大幅增加,更接近于欧美国家的剂量,血药浓度监测例数大幅增长,谷浓度阈值达标率大大提升,更佳的平均血药谷浓度使得临床疗效得以提升。

Abstract

OBJECTIVE To explore the necessity of conducting drug monitoring for the treatment of teicoplanin and to compare the results of two investigations in our hospital in this respect, and to explore the progress of clinical rational use of teicoplanin. METHODS A cross-sectional investigation was used to collect the clinical data of 73 inpatients who received our hospital monitoring of teicoplanin in the China-Japan Friendship from January 1, 2020 to December 31, 2020. The monitoring data of 111 cases of plasma drug concentration were statistically analyzed,and compared with the survey results of 2018. RESULTS The median trough concentration of teicoplanin was 17.31(12.04,29.59) mg·L-1(2020) vs(7.77±4.31) mg·L-1(2018).Serum trough concentration > 10 mg·L-1 89 cases(80.18%)(2020)vs 11 cases(27.50%)(2018);Serum trough concentration > 20 mg·L-1 46 cases(41.44%)(2020)vs 1 case(2.50%)(2018);95.71%(2020) vs 53.01%(2018) were given loading dose(P<0.0001), with 600 mg q12h(57.14%)(2020) vs 400 mg q12h(63.92%)(2018) being the most frequently dosage regimen.The most frequently used maintenance dose was 600 mg qd(28.77%)(2020) vs 400 mg qd(32.24%)(2018). In 2020,the mean white blood cell count, neutrophil percentage and procalcitonin(PCT) level of patients with serum trough concentration within the normal range(10~20 mg·L-1) were significantly decreased after treatment with teicoplanin.Overall effective rate was significantly improved(93.15% vs 50.82%, P<0.000 1). CONCLUSION Compared with the investigation in 2018, the average drug dose of teicoplanin increases significantly, which is closer to the dose used in European and American countries. The number of cases monitored for plasma drug concentration increases significantly, and the threshold compliance rate of trough concentration increases significantly. Better average trough concentration could improve the clinical efficacy.

关键词

替考拉宁 / 血药浓度 / 负荷剂量 / 横断面调查 / 对比研究

Key words

teicoplanin / plasmaconcentration / loading dose / cross-sectional investigation / comparative research

引用本文

导出引用
于宁, 张相林, 陈超阳, 郭冬杰, 张镭, 刘亚欧, 周颖, 崔一民. 替考拉宁治疗药物监测横断面调查对比研究[J]. 中国药学杂志, 2022, 57(11): 950-954 https://doi.org/10.11669/cpj.2022.11.012
YU Ning, ZHANG Xiang-lin, CHEN Chao-yang, GUO Dong-jie, ZHANG Lei, LIU Ya-ou, ZHOU Ying, CUI Yi-min. Comparative Research of Cross-sectional Investigation of Drug Monitoring in Treatment of Teicoplanin[J]. Chinese Pharmaceutical Journal, 2022, 57(11): 950-954 https://doi.org/10.11669/cpj.2022.11.012
中图分类号: R954   

参考文献

[1] SHEN C, CHEN W Q, ZHANG X L,et al.Progress of therapeutic drug monitoring on teicoplanin[J].Eval Anal Drug Use Hosp China(中国医院用药评价与分析),2019,19(7):890-894.
[2] LIANG B B, NI W T, WANG J,et al.Effectiveness and safety of teicoplanin versus vancomycin for the treatment of gram-positive bacterial infections:Meta-analysis of randomised controlled trials[J].Chin J Clin Pharmacol(中国临床药理学杂志),2017,33(2):176-180.
[3] OGAMI C,TSUJI Y,MURAKI Y,et al.Population pharmacokinetics and pharmacodynamics of teicoplanin and C-reactive protein in hospitalized patients with gram-positive infections[J].Clin Pharmacol Drug Dev,2020,9(2):175-188.
[4] Expert consensus group on clinical dosage of teicoplanin. Expert consensus on clinical dosage of teicoplanin[J].Chin J Tuberc Respir Dis(中华结核和呼吸杂志),2016,39(7):500-509.
[5] GUO D J, KONG X D, LI P M. Cross-sectional surveyon clinical practice and pharmaceutical care of teicoplanin[J]. Chin J Mod Appl Pharm(中国现代应用药学),2020,37(13):1642-1646.
[6] LI H, GAO L, ZHOU L, et al. Optimal teicoplanin loading regimen to rapidly achieve target trough plasma concentration in critically ill patients[J]. Basic Clin Pharmacol Toxicol,2020,126(3):277-288.
[7] MATTHEWS P C, CHUE A L, WYLLIE D, et al. Increased teicoplanin doses are associated with improved serum levels but not drug toxicity[J]. J Infect, 2014,68(1):43-49.
[8] JIA M M, ZHANG Q W, QIN Z F,et al.Monitoring the plasma concentrations and identifying the influence factors in patients with severe infections treated with different dosages of teicoplanin[J].Chin Pharm J(中国药学杂志),2021,56(18):1524-1529.
[9] UEDA T, TAKESUE Y, NAKAJIMA K,et al. Clinical efficacy and safety in patients treated with teicoplanin with a target trough concentration of 20 μg/mL using a regimen of 12 mg/kg for five doses within the initial 3 days[J]. BMC Pharmacol Toxicol, 2020,21(1):50.

基金

吴阶平医学基金会临床科研专项基金资助(320.6750.2020-04-18)
PDF(936 KB)

Accesses

Citation

Detail

段落导航
相关文章

/