The Most Suitable Dosage Regimen of Antibiotics for MRSA from Economical and Clinical Aspects.

从经济和临床角度分析MRSA最合适的抗生素剂量方案。

• 批准号: 11672247
• 负责人: MATSUYAMA Kenji
• 金额: $ 1.34万
• 依托单位: Mukogawa Women's University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1999
• 资助国家: 日本
• 起止时间: 1999 至 2000
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-11672247/
• 关键词: vancomycin; arbekacin; teicoplanin; cost-benefit; pharmacokinetics; MRSA; computer-simulation; コストと薬効; バイコマイシン; コンピュータシュミレーション

Purpose. The purpose of the study was to evaluate the most suitable dosages and dosing intervals on the basis of pharmacokinetic parameters for three kinds of antibiotics for MRSA infection, vancomycin (VCM), arbekacin (ABK) and teicoplanin (TEIC) from economical and clinical point of view.Methods. On the basis of pharmacokinetic mean-arameters of VCM obtained from Japanese, the computer simulation-study was performed by using one-compartment model analysis. Regarding to ABK and TEIC, the pharmacokinetic study was performed on each plasma concentration obtained from MRSA-patients by using Sawchuk-Zaske method.Results. In the case of VCM, we concluded that 1300 mg of VCM given once daily on commencing treatment of MRSA infection is the most suitable dosage regimen for Japanese adult patients because the regimen enable to increase the most suitable VCM peak concentration of 25-40 ug/mL and traugh level of under 10 ug/mL.In contrast, The dosage recommended in the Japanese version of the V … More CM package insert (500 mg of VCM given four times a day, or 1000 mg of VCM given twice a day) could not satisfy the concentration described above. From the economical point, the two weeks administration of VCM at a dose of 1300 mg once a day is cheaper by \67, 550 than the administration method described in package insert. In the case of ABK, 200 mg of ABK given once a day is found to be the most suitable dasage resimen for Japanese adult patient. Further, the pharmacokinetic parameter of TEIC was examined in 24 of adult MRSA patients. As a result, it was clarified that volume of distribution and clearance for TEIC are 0.6436 L/kg and 0.0018 L/kg/h, respectively. From the result, the administration of TEIC at a dose of 200 mg once a day is not enough to obtain an effective peak concentration of TEIC.The dose of 400 mg a day is found to be the most suitable dosage.The results obtained from the study gave the most useful clue for considering drug administration both from clinical and economical point of views. Less

目的。本研究的目的是从经济和临床角度出发，根据万古霉素（VCM）、阿贝卡星（ABK）和替考拉宁（TEIC）3种抗生素治疗MRSA感染的药代动力学参数，评估最合适的剂量和给药间隔。方法。在日本获得的VCM药动学平均参数的基础上，采用一室模型分析进行了计算机模拟研究。对于ABK和TEIC，使用Sawchuk-Zaske方法对从MRSA患者获得的每种血浆浓度进行药代动力学研究。结果。就 VCM 而言，我们得出的结论是，开始治疗 MRSA 感染时每日一次给予 1300 mg VCM 是日本成年患者最合适的剂量方案，因为该方案能够将最合适的 VCM 峰浓度提高到 25-40 ug/mL，谷浓度低于 10 ug/mL。相比之下，日本版 V … More CM 说明书中推荐的剂量（500 mg 剂量） 每天给予四次VCM，或每天两次给予1000毫克VCM）不能满足上述浓度。从经济角度来看，每天一次1300mg剂量的VCM两周给药比包装说明书中描述的给药方法便宜67、550日元。就 ABK 而言，每天一次 200 毫克的 ABK 被认为是日本成年患者最合适的剂量方案。此外，在 24 名成年 MRSA 患者中检查了 TEIC 的药代动力学参数。结果表明，TEIC的分布容积和清除量分别为0.6436L/kg和0.0018L/kg/h。从结果来看，每天一次200mg的TEIC给药剂量不足以获得TEIC的有效峰浓度。发现每天400mg的剂量是最合适的剂量。该研究获得的结果为从临床和经济角度考虑给药提供了最有用的线索。较少的

项目成果

Kenji Matsuyama et al.: "Optimal Dosage Regimen for Vancomycin in Japanese Patient"Am.J.Hosp.Pharm.. (投稿中).

Kenji Matsuyama 等人：“日本患者万古霉素的最佳剂量方案”Am.J.Hosp.Pharm..（进行中）。

Kenji Matsuyama et.al.: "Optimal Dosage Regimen for Vancomycin in Japanese Patient"Journal of Applied Therapeutic Research. (Accepted). (2001)

Kenji Matsuyama 等人：“日本患者万古霉素的最佳剂量方案”应用治疗研究杂志。