Colistin Methanesulfonate and Colistin Pharmacokinetics in Critically Ill Patients Receiving Continuous Venovenous Hemodiafiltration
Colistin Methanesulfonate and Colistin Pharmacokinetics in Critically Ill Patients Receiving Continuous Venovenous Hemodiafiltration
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DOI：
10.1128/aac.00985-12
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发表时间：
2013-01-01
影响因子：
4.9
通讯作者：
Giamarellou, Helen
中科院分区：
文献类型：
--
作者：
Karvanen, Matti;Plachouras, Diamantis;Giamarellou, Helen
本文报道了5例接受连续性静脉-静脉血液透析滤过的重症监护病房患者应用粘菌素、甲磺酸粘菌素(CMS)和粘菌素的药代动力学。对于CMS，第四次给药后的平均最大血药浓度(C-max)为6.92 mg/L，总清除量(CL)为8.23升/小时。粘菌素(Colistin)的平均浓度为0.92 mg/L，CL/代谢组分(f(M))为18.91升/h。粘菌素浓度低于当前MIC临界点，药物在稳态下24小时内的游离、游离部分的浓度-时间曲线下面积(Fauc/MIC)低于推荐值。提示160mgCMS每8h(Q8h)给药方案是不够的。
This report describes the pharmacokinetics of colistin methanesulfonate (CMS) and colistin in five intensive care unit patients receiving continuous venovenous hemodiafiltration. For CMS, the mean maximum concentration of drug in plasma (C-max) after the fourth dose was 6.92 mg/liter and total clearance (CL) 8.23 liters/h. For colistin, the mean concentration was 0.92 mg/liter and CL/metabolized fraction (f(m)) 18.91 liters/h. Colistin concentrations were below the current MIC breakpoints, and the area under the concentration-time curve for the free, unbound fraction of the drug over 24 h in the steady state divided by the MIC (fAUC/MIC) was lower than recommended, suggesting that a dosage regimen of 160 mg CMS every 8 h (q8h) is inadequate.