Antimicrobial dosing design during continuous hemodiafiltration considering under-dosing

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Other Title
  • Under Dosingを回避することを考慮した，持続的血液濾過透析施行中のβラクタム系抗菌薬の投与設計

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Description

<p>Beta-lactams have recently emerged as extensively utilized antimicrobial agents, and their judicious administration significantly influences the outcome of critically ill patients. In critical illness, the pharmacokinetics of beta-lactams deviate markedly from those observed in healthy individuals, exhibiting considerable temporal variability and interindividual differences related to disease status. In clinical practice, beta-lactam dosage adjustments are commonly implemented based on the renal replacement therapy (RRT) setting. However, significant variability is known to exist in blood concentrations, primarily due to underlying pharmacokinetic changes. Despite attempts to estimate approximate clearance from the RRT setting, detecting patients who deviates optimal drug concentration remains challenging due to this variability. Conversely, beta-lactams demonstrate a favorable safety profile; however, dose reductions are recommended when trough concentrations surpass 6 to 10 times the Minimum Inhibitory Concentration (MIC) considering their potential toxicity. This recommendation holds particular significance in the early stages of severe diseases, where pharmacokinetics are unpredictable and patient outcomes are substantially influenced. Consequently, this emphasizes the desirability of dosing strategies aimed at ensuring sufficient blood levels.</p>

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Details 詳細情報について

  • CRID
    1390867344225294976
  • DOI
    10.34325/jsbpcc.15.2_93
  • ISSN
    2434219X
    21851085
  • Text Lang
    ja
  • Data Source
    • JaLC
  • Abstract License Flag
    Disallowed

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