广州医药 ›› 2023, Vol. 54 ›› Issue (2): 24-28.DOI: 10.3969/j.issn.1000-8535.2023.02.004

• 论著 • 上一篇    下一篇

《2022 JSC/JSTDM临床实践指南:替考拉宁治疗药物监测》解读

王润   

  1. 红河哈尼族彝族自治州中医医院(红河 654399)
  • 收稿日期:2022-02-19 出版日期:2023-02-20 发布日期:2023-02-27

Interpretation of Clinical practice guidelines for therapeutic drug monitoring of teicoplanin: a consensus review by the Japanese Society of Chemotherapy and the Japanese Society of Therapeutic Drug Monitoring

WANG Run   

  1. Honghe Hani and Yi Autonomous Prefecture Hospital of Traditional Chinese Medicine, Honghe 654399, China
  • Received:2022-02-19 Online:2023-02-20 Published:2023-02-27

摘要: 目的 为临床合理使用替考拉宁以及更好地管理接受替考拉宁治疗的患者。方法 从药学角度对2022年日本《2022 JSC/JSTDM临床实践指南:替考拉宁治疗药物监测》(简称《指南》)涉及替考拉宁治疗的9个临床问题进行解读。结果 《指南》指出药-时曲线下面积/最小抑菌浓度是替考拉宁的关键药动学/药效学参数。替考拉宁治疗药物监测(TDM)的目的是明确目标谷浓度(Cmin),对于严重或复杂的耐甲氧西林金黄色葡萄球菌(MRSA)感染,指南建议替考拉宁Cmin为20~40 mg/L。肾功能正常或轻度受损的非复杂性的MRSA感染,目标Cmin为15~30 mg/L。严重和/或复杂性MRSA感染,如感染性心内膜炎和骨髓炎,替考拉宁Cmin为20~40 mg/L。结论 《指南》针对不同病理状态下患者替考拉宁目标Cmin的确定,为临床治疗中替考拉宁TDM、个体化给药提供参考。

关键词: 替考拉宁, 治疗药物监测, 耐甲氧西林金黄色葡萄球菌, 指南解读, 目标谷浓度

Abstract: Objective To make rational use of teicoplanin and better management of patients treated with teicoplanin. Methods Nine clinical issues related to the treatment of teicoplanin in Clinical practice guidelines for therapeutic drug monitoring of teicoplanin: a consensus review by the Japanese Society of Chemotherapy and the Japanese Society of Therapeutic Drug Monitoring (Japan, 2022) were interpreted from the perspective of pharmacy. Results The guidelines indicated that the area under drug-time curve/minimum inhibitory concentration was the key pharmacokinetic/pharmacodynamic parameters of teicoplanin.The purpose of therapeutic drug monitoring (TDM) of teicoplanin is to specify the target trough concentration (Cmin), which guidelines recommend for severe or complex methicillin-resistant Staphylococcus aureus (MRSA) infection is 20-40 mg/L.The target Cmin for uncomplicated MRSA infection with normal or mildly impaired renal function is 15-30 mg/L.For severe and/or complex MRSA infections, such as infective endocarditis and osteomyelitis, the Cmin of teicoplanin was 20-40 mg/L. Conclusions The guidelines are aimed at the determination of target Cmin of teicoplanin in patients with different pathological conditions, and provide reference for individual drug administration and teicoplanin TDM in clinical treatment.

Key words: teicoplanin, TDM, MRSA, guide interpretation, Cmin