Clin Pharmacol Ther:干货!严重急性营养不良婴幼儿 头孢曲松和甲硝唑给药剂量知多少

2018-12-18 常路 环球医学

严重急性营养不良(SAM)的婴儿和幼童都接受经验性广谱抗生素。肠外头孢曲松目前是侵袭性感染的二线治疗药物。口服甲硝唑主要针对小肠细菌过度生长。严重急性营养不良儿童可改变药物吸收、分布、代谢和消除。2018年12月,发表在《Clin Pharmacol Ther.》的一项研究调查了,严重急性营养不良儿童头孢曲松和甲硝唑的给药剂量。

严重急性营养不良(SAM)的婴儿和幼童都接受经验性广谱抗生素。肠外头孢曲松目前是侵袭性感染的二线治疗药物。口服甲硝唑主要针对小肠细菌过度生长。严重急性营养不良儿童可改变药物吸收、分布、代谢和消除。2018年12月,发表在《Clin Pharmacol Ther.》的一项研究调查了,严重急性营养不良儿童头孢曲松和甲硝唑的给药剂量。

研究人员研究头孢曲松和甲硝唑的群体药物代谢动力学,旨在推荐最佳药物剂量。

81名严重急性营养不良儿童(2~45月龄)提供了234份总体头孢曲松、甲硝唑和羟基甲硝唑的给药后药物代谢动力学样本。对其中的190份样本也测量了头孢曲松蛋白结合。三室模型充分描述了游离头孢曲松,米氏模型描述了浓度和白蛋白依赖性蛋白结合。单室模型用于甲硝唑和羟基甲硝唑,预计仅有1%的羟基甲硝唑在首过期间形成。

模拟显示,80mg/kg每天一次的头孢曲松和12.5mg/kg每天两次的甲硝唑足以达到治疗目标。

原始出处:

Standing JF, Ongas MO, Ogwang C, et al. Dosing of Ceftriaxone and Metronidazole for Children With Severe Acute Malnutrition. Clin Pharmacol Ther. 2018 Dec;104(6):1165-1174. doi: 10.1002/cpt.1078.

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    2019-04-03 yb6560
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    2019-11-21 jj000001
  5. [GetPortalCommentsPageByObjectIdResponse(id=1996246, encodeId=cad2199624627, content=<a href='/topic/show?id=ed881120ec8' target=_blank style='color:#2F92EE;'>#MAC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11207, encryptionId=ed881120ec8, topicName=MAC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4b65161, createdName=yb6560, createdTime=Wed Apr 03 17:02:00 CST 2019, time=2019-04-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1908493, encodeId=b16a19084935b, content=<a href='/topic/show?id=a8d0141605e' target=_blank style='color:#2F92EE;'>#pharma#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14160, encryptionId=a8d0141605e, topicName=pharma)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Sat Mar 30 16:02:00 CST 2019, time=2019-03-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1788342, encodeId=7c3a1e88342cf, content=<a href='/topic/show?id=38e014162e2' target=_blank style='color:#2F92EE;'>#Pharmacol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14162, encryptionId=38e014162e2, topicName=Pharmacol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=930e243, createdName=dingxiaobo, createdTime=Tue May 14 03:02:00 CST 2019, time=2019-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1787557, encodeId=34e01e87557cc, content=<a href='/topic/show?id=fa03141591e' target=_blank style='color:#2F92EE;'>#Pharm#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14159, encryptionId=fa03141591e, topicName=Pharm)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Thu Nov 21 16:02:00 CST 2019, time=2019-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1299295, encodeId=b4651299295ec, content=<a href='/topic/show?id=5413699307e' target=_blank style='color:#2F92EE;'>#甲硝唑#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69930, encryptionId=5413699307e, topicName=甲硝唑)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3860283, createdName=whmdzju, createdTime=Thu Dec 20 08:02:00 CST 2018, time=2018-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1379568, encodeId=c37c13e9568e8, content=<a href='/topic/show?id=d9694434815' target=_blank style='color:#2F92EE;'>#头孢曲松#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44348, encryptionId=d9694434815, topicName=头孢曲松)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=37d0457, createdName=yhj-time, createdTime=Thu Dec 20 08:02:00 CST 2018, time=2018-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1459555, encodeId=26ad14595555a, content=<a href='/topic/show?id=82a24434020' target=_blank style='color:#2F92EE;'>#头孢#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44340, encryptionId=82a24434020, topicName=头孢)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=acae6165124, createdName=jj000003, createdTime=Thu Dec 20 08:02:00 CST 2018, time=2018-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=355767, encodeId=47db355e6744, content=了解一下,谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Tue Dec 18 21:10:05 CST 2018, time=2018-12-18, status=1, ipAttribution=)]
    2018-12-20 whmdzju
  6. [GetPortalCommentsPageByObjectIdResponse(id=1996246, encodeId=cad2199624627, content=<a href='/topic/show?id=ed881120ec8' target=_blank style='color:#2F92EE;'>#MAC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11207, encryptionId=ed881120ec8, topicName=MAC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4b65161, createdName=yb6560, createdTime=Wed Apr 03 17:02:00 CST 2019, time=2019-04-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1908493, encodeId=b16a19084935b, content=<a href='/topic/show?id=a8d0141605e' target=_blank style='color:#2F92EE;'>#pharma#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14160, encryptionId=a8d0141605e, topicName=pharma)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Sat Mar 30 16:02:00 CST 2019, time=2019-03-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1788342, encodeId=7c3a1e88342cf, content=<a href='/topic/show?id=38e014162e2' target=_blank style='color:#2F92EE;'>#Pharmacol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14162, encryptionId=38e014162e2, topicName=Pharmacol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=930e243, createdName=dingxiaobo, createdTime=Tue May 14 03:02:00 CST 2019, time=2019-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1787557, encodeId=34e01e87557cc, content=<a href='/topic/show?id=fa03141591e' target=_blank style='color:#2F92EE;'>#Pharm#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14159, encryptionId=fa03141591e, topicName=Pharm)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Thu Nov 21 16:02:00 CST 2019, time=2019-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1299295, encodeId=b4651299295ec, content=<a href='/topic/show?id=5413699307e' target=_blank style='color:#2F92EE;'>#甲硝唑#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69930, encryptionId=5413699307e, topicName=甲硝唑)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3860283, createdName=whmdzju, createdTime=Thu Dec 20 08:02:00 CST 2018, time=2018-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1379568, encodeId=c37c13e9568e8, content=<a href='/topic/show?id=d9694434815' target=_blank style='color:#2F92EE;'>#头孢曲松#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44348, encryptionId=d9694434815, topicName=头孢曲松)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=37d0457, createdName=yhj-time, createdTime=Thu Dec 20 08:02:00 CST 2018, time=2018-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1459555, encodeId=26ad14595555a, content=<a href='/topic/show?id=82a24434020' target=_blank style='color:#2F92EE;'>#头孢#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44340, encryptionId=82a24434020, topicName=头孢)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=acae6165124, createdName=jj000003, createdTime=Thu Dec 20 08:02:00 CST 2018, time=2018-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=355767, encodeId=47db355e6744, content=了解一下,谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Tue Dec 18 21:10:05 CST 2018, time=2018-12-18, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=1996246, encodeId=cad2199624627, content=<a href='/topic/show?id=ed881120ec8' target=_blank style='color:#2F92EE;'>#MAC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11207, encryptionId=ed881120ec8, topicName=MAC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4b65161, createdName=yb6560, createdTime=Wed Apr 03 17:02:00 CST 2019, time=2019-04-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1908493, encodeId=b16a19084935b, content=<a href='/topic/show?id=a8d0141605e' target=_blank style='color:#2F92EE;'>#pharma#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14160, encryptionId=a8d0141605e, topicName=pharma)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Sat Mar 30 16:02:00 CST 2019, time=2019-03-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1788342, encodeId=7c3a1e88342cf, content=<a href='/topic/show?id=38e014162e2' target=_blank style='color:#2F92EE;'>#Pharmacol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14162, encryptionId=38e014162e2, topicName=Pharmacol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=930e243, createdName=dingxiaobo, createdTime=Tue May 14 03:02:00 CST 2019, time=2019-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1787557, encodeId=34e01e87557cc, content=<a href='/topic/show?id=fa03141591e' target=_blank style='color:#2F92EE;'>#Pharm#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14159, encryptionId=fa03141591e, topicName=Pharm)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Thu Nov 21 16:02:00 CST 2019, time=2019-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1299295, encodeId=b4651299295ec, content=<a href='/topic/show?id=5413699307e' target=_blank style='color:#2F92EE;'>#甲硝唑#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69930, encryptionId=5413699307e, topicName=甲硝唑)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3860283, createdName=whmdzju, createdTime=Thu Dec 20 08:02:00 CST 2018, time=2018-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1379568, encodeId=c37c13e9568e8, content=<a href='/topic/show?id=d9694434815' target=_blank style='color:#2F92EE;'>#头孢曲松#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44348, encryptionId=d9694434815, topicName=头孢曲松)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=37d0457, createdName=yhj-time, createdTime=Thu Dec 20 08:02:00 CST 2018, time=2018-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1459555, encodeId=26ad14595555a, content=<a href='/topic/show?id=82a24434020' target=_blank style='color:#2F92EE;'>#头孢#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44340, encryptionId=82a24434020, topicName=头孢)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=acae6165124, createdName=jj000003, createdTime=Thu Dec 20 08:02:00 CST 2018, time=2018-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=355767, encodeId=47db355e6744, content=了解一下,谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Tue Dec 18 21:10:05 CST 2018, time=2018-12-18, status=1, ipAttribution=)]
    2018-12-20 jj000003
  8. [GetPortalCommentsPageByObjectIdResponse(id=1996246, encodeId=cad2199624627, content=<a href='/topic/show?id=ed881120ec8' target=_blank style='color:#2F92EE;'>#MAC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11207, encryptionId=ed881120ec8, topicName=MAC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4b65161, createdName=yb6560, createdTime=Wed Apr 03 17:02:00 CST 2019, time=2019-04-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1908493, encodeId=b16a19084935b, content=<a href='/topic/show?id=a8d0141605e' target=_blank style='color:#2F92EE;'>#pharma#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14160, encryptionId=a8d0141605e, topicName=pharma)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Sat Mar 30 16:02:00 CST 2019, time=2019-03-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1788342, encodeId=7c3a1e88342cf, content=<a href='/topic/show?id=38e014162e2' target=_blank style='color:#2F92EE;'>#Pharmacol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14162, encryptionId=38e014162e2, topicName=Pharmacol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=930e243, createdName=dingxiaobo, createdTime=Tue May 14 03:02:00 CST 2019, time=2019-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1787557, encodeId=34e01e87557cc, content=<a href='/topic/show?id=fa03141591e' target=_blank style='color:#2F92EE;'>#Pharm#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14159, encryptionId=fa03141591e, topicName=Pharm)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Thu Nov 21 16:02:00 CST 2019, time=2019-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1299295, encodeId=b4651299295ec, content=<a href='/topic/show?id=5413699307e' target=_blank style='color:#2F92EE;'>#甲硝唑#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69930, encryptionId=5413699307e, topicName=甲硝唑)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3860283, createdName=whmdzju, createdTime=Thu Dec 20 08:02:00 CST 2018, time=2018-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1379568, encodeId=c37c13e9568e8, content=<a href='/topic/show?id=d9694434815' target=_blank style='color:#2F92EE;'>#头孢曲松#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44348, encryptionId=d9694434815, topicName=头孢曲松)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=37d0457, createdName=yhj-time, createdTime=Thu Dec 20 08:02:00 CST 2018, time=2018-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1459555, encodeId=26ad14595555a, content=<a href='/topic/show?id=82a24434020' target=_blank style='color:#2F92EE;'>#头孢#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44340, encryptionId=82a24434020, topicName=头孢)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=acae6165124, createdName=jj000003, createdTime=Thu Dec 20 08:02:00 CST 2018, time=2018-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=355767, encodeId=47db355e6744, content=了解一下,谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Tue Dec 18 21:10:05 CST 2018, time=2018-12-18, status=1, ipAttribution=)]
    2018-12-18 天地飞扬

    了解一下,谢谢分享!

    0

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