Full
Outline
To characterize the pharmacokinetic characteristics of teicoplanin in patients with hypoalbuminemia, explore the target values of pharmacokinetic/pharmacodynamic (PK/PD) parameters, and develop individualized dosing regimens.
Clinical data of patients with hypoalbuminemia were retrospectively collected, and a population pharmacokinetic analysis was performed using a nonlinear mixed-effects model. Classification and regression tree (CART) analysis and survival analysis were used to explore and verify the impact of the target values of (PK/PD) parameters on therapeutic efficacy. Monte Carlo simulation was applied to develop individualized dosing regimens.
A one-compartment population pharmacokinetic model of teicoplanin was established using 328 blood concentration values from 195 patients. The population typical values of clearance and apparent volume of distribution of the model were 0.612 L·h-1 and 91.2 L, respectively. Estimated glomerular filtration rate (eGFR) was included as a covariate for clearance, and albumin and urea were included as covariates for the apparent volume of distribution. The target values of PK/PD parameters were determined as trough concentration ≥15 mg·L-1 and the ratio of 24 hour area under the drug-time curve to minimum inhibitory concentration (AUC24/MIC)≥790. Several individualized dosing regimens were developed based on different levels of the model covariates.
For patients with hypoalbuminemia receiving teicoplanin, it is necessary to increase the dosage and frequency of the loading dose regimen according to the patients' albumin and eGFR levels, and adjust the maintenance dose regimen according to the MIC of pathogenic bacteria, so as to improve clinical efficacy.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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