The pharmacokinetics of ampicillin-sulbactam in anuric patients: dosing optimization for prophylaxis during cardiovascular surgery.
The pharmacokinetics of ampicillin-sulbactam in anuric patients: dosing optimization for prophylaxis during cardiovascular surgery.
复制标题
无尿患者中氨苄西林-舒巴坦的药代动力学：心血管手术期间预防的剂量优化。
DOI：
10.1007/s11096-016-0286-5
复制
发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Takeda Y.
中科院分区：
文献类型：
--
作者：
Yokoyama Y;Matsumoto K;Ikawa K;Watanabe E;Yamamoto H;Imoto Y;Morikawa N;Takeda Y.
背景：在心胸外科手术中应用抗生素预防可以降低手术部位的感染率。胸腔抗生素预防试验发现，它有利于预防术后伤口感染。目的探讨无尿患者心血管外科手术中反复给药氨苄西林-舒巴坦的合适时机，以维持足够的抗生素浓度。方法在鹿儿岛大学医院心血管手术中接受氨苄西林-舒巴坦治疗的5例成人无尿透析患者，监测氨苄西林(1 g) -舒巴坦（0.5 g）给药后氨苄西林和舒巴坦的总血浆浓度。估计药代动力学参数并用于预测氨苄西林和舒巴坦的游离血浆浓度。结果氨苄西林的分布体积、总清除率、消除速率常数和消除半衰期的平均值分别为8.9±2.4 L、1.69±0.93 L/h、0.180±0.059 h−1和4.23±1.48 h。药动学参数与舒巴坦相似。氨苄西林(1 g) -舒巴坦（0.5 g）静脉给药，间隔8、12、24 h，预测氨苄西林游离谷血药浓度分别为28.72、12.06、1.25 μg/mL。结论建议心血管手术无尿患者每12 h静脉给予氨苄西林(1 g) -舒巴坦（0.5 g），可使游离氨苄西林浓度维持在12 μg/mL以上。
BackgroundThe administration of antibiotic prophylaxis during cardiothoracic surgery can reduce the rate of surgical site infections. Trials of cardiothoracic antibiotic prophylaxis have found it to be beneficial in preventing postoperative wound infections.ObjectiveTo determine the more appropriate timing of repeated doses of ampicillin–sulbactam to maintain adequate antibiotic concentrations during cardiovascular surgery in anuric patients.MethodFive adult anuric dialysis patients who received ampicillin–sulbactam during cardiovascular surgery at Kagoshima University Hospital, the total plasma concentrations of ampicillin and sulbactam were monitored after ampicillin (1 g)–sulbactam (0.5 g) administration. Pharmacokinetic parameters were estimated and used to predict the free plasma concentrations of ampicillin and sulbactam.ResultsThe mean values for the volume of distribution, total clearance, elimination rate constant and the elimination half-life for ampicillin were 8.9 ± 2.4 L, 1.69 ± 0.93 L/h, 0.180 ± 0.059 h−1and 4.23 ± 1.48 h, respectively. The pharmacokinetic parameters were similar to those of sulbactam. When ampicillin (1 g)–sulbactam (0.5 g) was intravenously administered at 8, 12 and 24 h intervals, the predicted free trough plasma concentrations of ampicillin were 28.72, 12.06 and 1.25 μg/mL, respectively.ConclusionWe suggest that ampicillin (1 g)–sulbactam (0.5 g) should be intravenously administered every 12 h in order to maintain a free ampicillin concentration of more than 12 μg/mL in anuric patients during cardiovascular surgery.