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首页> 外文期刊>Infection >Optimal tobramycin dosage in patients with cystic fibrosis--evidence for predictability based on previous drug monitoring.
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Optimal tobramycin dosage in patients with cystic fibrosis--evidence for predictability based on previous drug monitoring.

机译：囊性纤维化患者的妥布霉素最佳剂量-基于先前药物监测的可预测性证据。

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A retrospective analysis of files of patients with cystic fibrosis and pulmonary exacerbations was performed to investigate whether an individual dosage of tobramycin once established by serum level determination allows a reliable prediction of the adequate dosage in a consecutive exacerbation. All patients hospitalized > or = 2 times between May 1997 and September 1998 with pulmonary exacerbation due to Pseudomonas aeruginosa infection susceptible to tobramycin were included.The initial dosage to tobramycin was 5 mg/kg body weight every 12 h followed by drug level determinations to establish the optimal dose. In a consecutive exacerbation the same dosage per kg body weight was used again and drug level determinations were repeated. Sixteen patients (six female = 38%) with a mean age of 24 years (median: 26 years, range: 9-33) were hospitalized for 49 pulmonary exacerbations (2-6 per patient, mean: 3, median: 2.5). During the first episode of tobramycin treatment in the study period all trough levels were < 2 microg/ml (median: 0.6) and the peak levels were 7.1-16.9 microg/ml (median: 11.9). In four patients the peak level was > 12 microg/ml. In 28 consecutive episodes the dosage of tobra myci n was chosen based on optimal results of previous drug level monitoring and in 27 instances (96%) the previously established optimal dose was confirmed. In five consecutive episodes the tobramycin dosage had been increased erroneously and this resulted in abnormally high peak levels in three cases. These findings suggest that a safe and therapeutic tobramycin dosage in an individual patient with cystic fibrosis is predictable based on a previously established optimal dosage.
机译：回顾性分析了囊性纤维化和肺部加重患者的病历，以调查通过血清水平测定确定的妥布霉素单剂量是否可以可靠地预测连续加重的适当剂量。在1997年5月至1998年9月之间所有因肺炎性铜绿假单胞菌感染易受妥布霉素影响而加重肺病加重的≥2次住院患者。妥布霉素的初始剂量为每12小时5 mg / kg体重，然后进行药物水平测定以确定最佳剂量。在连续发作中，再次使用每公斤体重相同的剂量，并重复测定药物水平。平均年龄为24岁（中位数：26岁，范围：9-33）的16例患者（六名女性= 38％）因49例肺病加重住院（每例患者2-6，平均：3，中位数：2.5）。在研究期的妥布霉素治疗的第一阶段中，所有谷值均<2 microg / ml（中位数：0.6），峰值水平为7.1-16.9 microg / ml（中位数：11.9）。在四名患者中，峰值水平> 12 microg / ml。在28次连续发作中，基于先前药物水平监测的最佳结果选择了妥布霉素的剂量，在27种情况下（96％）确认了先前确定的最佳剂量。在五次连续发作中，妥布霉素剂量错误增加，导致三例出现异常高峰值水平。这些发现表明，基于先前确定的最佳剂量，在患有囊性纤维化的个体患者中妥布霉素的安全和治疗剂量是可预测的。

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