The efficacy and safety of high-dose arbekacin sulfate therapy (once-daily treatment) in patients with MRSA infection

被引:9
作者
Yamamoto, Yoshihiro [1 ]
Izumikawa, Koichi [1 ]
Hashiguchi, Koji [2 ]
Fukuda, Yuichi [3 ]
Kobayashi, Tsutomu [4 ]
Kondo, Akira [5 ]
Inoue, Yuichi [5 ]
Morinaga, Yoshitomo [6 ]
Nakamura, Shigeki [1 ]
Imamura, Yoshifumi [1 ]
Miyazaki, Taiga [1 ]
Kakeya, Hiroshi [1 ]
Yanagihara, Katsunori [6 ]
Kohno, Shigeru [1 ]
机构
[1] Nagasaki Univ, Dept Mol Microbiol & Immunol, Grad Sch Biomed Sci, Nagasaki 8528501, Japan
[2] Japanese Red Cross Nagasaki Genbaku Hosp, Dept Resp Med, Nagasaki, Japan
[3] Sasebo City Gen Hosp, Dept Resp Med, Nagasaki, Japan
[4] Sasebo Chuo Hosp, Dept Resp Med, Nagasaki, Japan
[5] Hlth Insurance Isahaya Gen Hosp, Dept Resp Med, Nagasaki, Japan
[6] Nagasaki Univ Hosp, Dept Clin Lab, Nagasaki 8528501, Japan
关键词
Arbekacin; Methicillin-resistant Staphylococcus aureus; Pneumonia; Sepsis; RESISTANT STAPHYLOCOCCUS-AUREUS; PSEUDOMONAS-AERUGINOSA; VANCOMYCIN;
D O I
10.1007/s10156-012-0397-4
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
The efficacy and safety of once-daily high-dose arbekacin sulfate therapy for methicillin-resistant Staphylococcus aureus (MRSA) infection were evaluated, with analysis of their relationship to blood drug levels. The study was conducted in patients with pneumonia or sepsis, the cause of which was suspected to be MRSA, who were admitted to the Nagasaki University Hospital or its affiliated hospitals between January 2009 and December 2010. The initial drug dose was set at a level expected to yield the goal peak of 20 mu g/ml and a trough level of less than 2 mu g/ml, using the Habekacin Therapeutic Drug Monitoring analysis software. Thirteen patients were enrolled: 10 patients had pneumonia and 3 patients had sepsis. Patient mean age was 72.0 years; mean initial drug dose was 269.2 mg. Clinical efficacy at completion of treatment and bacterial eradication-reduction were achieved in 66.7% (6/9) and 62.5% (5/8) of patients, respectively. Incidence of adverse reactions was 38.5% (5/13). In analysis of efficacy in relationship to serum drug levels, the peak drug level was 22.7 +/- A 5.50 mu g/ml, on average, and 15 mu g/ml or higher in all 6 responders. Also, in patients with renal dysfunction, it seemed to be essential to ensure a certain peak drug level and to control the trough level appropriately. Although the number of patients was limited, once-daily high-dose arbekacin sulfate therapy may be highly effective, without posing any major safety problems. Further larger-scale studies are needed.
引用
收藏
页码:241 / 246
页数:6
相关论文
共 14 条
[1]  
AIKAWA N, 2008, JPN J CHEMOTHER, V56, P299
[2]  
[Anonymous], Japan Nosocomial Infections Surveillance
[3]  
FUJIMURA S, 2009, JPN J CHEMOTHER, V57, P91
[4]  
Kawano H, 2010, JPN J THER DRUG MONI, V27, P55
[5]  
Kurazono M, 2002, J JPN CHEMOTHER, V50, P494
[6]   Clinical glycopeptide-intermediate staphylococci tested against arbekacin, daptomycin, and tigecycline [J].
LaPlante, KL ;
Rybak, MJ .
DIAGNOSTIC MICROBIOLOGY AND INFECTIOUS DISEASE, 2004, 50 (02) :125-130
[7]  
Saito A, 1997, JPN J CHEMOTHER, V45, P762
[8]   Pharmacokinetic-pharmacodynamic relationship of arbekacin for treatment of patients infected with methicillin-resistant Staphylococcus aureus [J].
Sato, Reiko ;
Tanigawara, Yusuke ;
Kaku, Mitsuo ;
Aikawa, Naoki ;
Shimizu, Kihachiro .
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 2006, 50 (11) :3763-3769
[9]   Vancomycin MIC creep in non-vancomycin-intermediate Staphylococcus aureus (VISA), vancomycin-susceptible clinical methicillin-resistant S-aureus (MRSA) blood isolates from 2001-05 [J].
Steinkraus, Gregory ;
White, Roger ;
Friedrich, Lawrence .
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, 2007, 60 (04) :788-794
[10]   Population pharmacokinetics of arbekacin in patients infected with methicillin-resistant Staphylococcus aureus [J].
Tanigawara, Yusuke ;
Sato, Reiko ;
Morita, Kunihiko ;
Kaku, Mitsuo ;
Aikawa, Naoki ;
Shimizu, Kihachiro .
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 2006, 50 (11) :3754-3762