Early target attainment of azithromycin therapy in children with lower respiratory tract infections
Early target attainment of azithromycin therapy in children with lower respiratory tract infections
复制标题
阿奇霉素治疗下呼吸道感染儿童的早期目标
DOI：
10.1093/jac/dky273
复制
发表时间：
2018-10-01
影响因子：
5.2
通讯作者：
Shen, Adong
中科院分区：
文献类型：
--
作者：
Liu, Shuping;Zheng, Yi;Shen, Adong
目的早期达标是影响抗菌药物治疗效果的关键因素。本研究旨在评价阿奇霉素在治疗24~48 h内的血药浓度与临床疗效的关系，以优化抗菌治疗。结果44例患儿[平均年龄(SD) = 5.25(3.72)岁]均进入结果分析。与低谷浓度≤0.25 mg/L组(n=36)相比，低谷浓度组(n=8)在降低C反应蛋白(P=0.006)和中性粒细胞百分率(P=0.043)方面的抗菌效果明显优于低谷浓度组(n=8)。未发现与阿奇霉素治疗有因果关系的药物相关不良事件。结论我们的研究显示了阿奇霉素治疗早期达标的临床益处。为确保较好的抗菌效果，入院前24~48 h的目标浓度谷值应为0.25 mg/L。
ObjectivesEarly target attainment is the key factor influencing the outcome of antimicrobial therapy. The objective of the present study was to evaluate the relationship between azithromycin concentrations during the first 24–48 h of therapy and the clinical outcome in order to optimize antimicrobial therapy.MethodsAll children with lower respiratory tract infections receiving intravenous azithromycin monotherapy were included. The relationship between azithromycin trough concentrations during the first 24–48 h and the effectiveness and safety was explored.ResultsData from 44 children [mean (SD) age = 5.25 (3.72) years] were available for final analysis. Children with trough concentrations >0.25 mg/L (n=8) had a more significant improvement in antibacterial efficacy in terms of decreased C-reactive protein (P=0.006) and the percentage of neutrophils (P=0.043) compared with children with trough concentrations ≤0.25 mg/L (n=36). No drug-related adverse events were shown to have a causal association with azithromycin therapy.ConclusionsOur study showed the clinical benefits of early target attainment of azithromycin therapy. A target trough concentration of 0.25 mg/L in the first 24–48 h of hospitalization was required to ensure better antibacterial efficacy.