Influence of continuous renal replacement therapy on the plasma concentration of tigecycline in patients with septic shock: A prospective observational study.
Influence of continuous renal replacement therapy on the plasma concentration of tigecycline in patients with septic shock: A prospective observational study.
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DOI：
10.3389/fphar.2023.1118788
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发表时间：
2023
影响因子：
5.6
通讯作者：
中科院分区：
文献类型：
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作者：
目的：探讨连续性肾脏替代治疗(CRRT)对感染性休克患者大剂量替格环素稳态血药浓度的影响，为临床合理用药提供参考。方法：在这项前瞻性观察研究中，17例感染性休克患者在重症监护室接受大剂量替加环素(100 mg/12h)的广谱抗生素治疗，分为CRRT组(n=6)和非CRRT组(n=11)。采用岛津LC-20A和岛津LC-8040血药浓度检测仪测定血药浓度。组间稳态血药浓度比较采用非配对t检验。此外，调整基准值的组间比较也使用多变量线性回归模型进行。结果：CRRT组替格环素峰浓度(Cmax)较非CRRT组升高，但差异无统计学意义(505.11±143.84 vs.406.29±108.00 ng/mL，p值：0.129)。放疗组替格环素谷浓度(Cmin)明显高于非放疗组，差异有统计学意义(287.92±41.91vs.174.79±33.15ngmL，p值：0.000，调整后p值：0.000)。在安全性方面，Cmin被报道为一种有用的肝毒性预测因子，其临界值为474.8 ng/mL。在我们的研究中，CRRT组所有患者的Cmin均低于474.8 ng/mL。结论：感染性休克患者接受CRRT治疗后，替吉环素血药浓度升高，仅Cmin有统计学差异。从肝脏毒性的角度来看，似乎不需要调整剂量。临床试验注册：https://www.chictr.org.cn/，识别符ChiCTR2000037475。
Objective: The influence of continuous renal replacement therapy (CRRT) on the steady-state plasma concentration of high-dose tigecycline was investigated in septic shock patients to provide references for drug dosing. Methods: In this prospective observational study, 17 septic shock patients presenting with severe infections needing a broad-spectrum antibiotic therapy with high-dose tigecycline (100 mg per 12 h) in the intensive care unit were included and divided into CRRT group (n = 6) or non-CRRT group (n = 11). The blood samples were collected and plasma drug concentration was determined by SHIMADZU LC-20A and SHIMADZU LCMS 8040. The steady-state plasma concentration was compared between groups using unpaired t-test. Furthermore, between-groups comparisons adjusted for baseline value was also done using multivariate linear regression model. Results: Peak concentration (Cmax) of tigecycline was increased in CRRT group compared to non-CRRT group, but there were no statistical differences (505.11 ± 143.84 vs. 406.29 ± 108.00 ng/mL, p-value: 0.129). Trough concentration (Cmin) of tigecycline was significantly higher in CRRT group than in non-CRRT group, with statistical differences (287.92 ± 41.91 vs. 174.79 ± 33.15 ng/mL, p-value: 0.000, adjusted p-value: 0.000). In safety, Cmin was reported to be a useful predictor of hepatotoxicity with a cut-off of 474.8 ng/mL. In our studies, Cmin of all patients in CRRT group was lower than 474.8 ng/mL. Conclusion: The plasma concentration of tigecycline was increased in septic shock patients with CRRT treatment and only Cmin shown statistical differences. No dose adjustment seems needed in the view of hepatotoxicity. Clinical Trial Registration: https://www.chictr.org.cn/, identifier ChiCTR2000037475.
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影响因子：
2.9
作者：
Korth-Bradley, Joan M.;Troy, Steven M.;Raible, Donald G.
通讯作者：
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DOI：
10.1308/rcsann.2016.0126
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期刊：
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10.1016/j.ijantimicag.2011.02.004
发表时间：
2011-06-01
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