腎障害患者に対するｃｅｆｅｐｉｍｅの用法・用量の検討

• 吉次 広如

  ブリストル・マイヤーズ株式会社研究開発本部開発研究部

• 桜井 隆雄

  ブリストル・マイヤーズ株式会社研究開発本部開発研究部

• 平岡 聖樹

  ブリストル・マイヤーズ株式会社研究開発本部開発研究部

• 中名生 宏

  ブリストル・マイヤーズ株式会社研究開発本部開発研究部

書誌事項

タイトル別名

• Adjustment of cefepime dosage in patients with renal impairment

抄録

We studied dose regimens of cefepime (CFPM) in patients with renal impairment using population pharmacokinetic (PPK) modeling. PPK analysis incorporated body weight (BW) and creatinine clearance (Ccr) as covariates and was used to predict serum concentration-time profiles and pharmacokinetic (PK) parameters after 30-minute intravenous infusion at 0.5-2g of CFPM once (QD) or twice (BID) a day in patients with Ccr from 5 to 50mL/min and BW between 40kg and 90kg. For late-stage renal failure patients undergoing hemodialysis, PK profiles of CFPM after a 1g loading dose followed by 0.5g QD dose were estimated in patients with Ccr of 5mL min by a PPK model modified with hemodialysis clearance. Hemodialysis was modeled as three times a week just before CFPM 0.5g QD administration. T>MIC was used as the pharmacokinetic/pharmacodynamic (PK/PD) index and calculated using MIC₉₀ for Pseudomonas aeruginosa. Compared to the PK profile predicted at 2g BID for patient with normal renal function, results suggest the following:<BR>1. For patients with renal impairment managed without hemodialysis, CFPM 2 g BID for Ccr>50mL/min, 0.5-1g BID for Ccr 10-50mL min, and 0.5-1g QD for Ccr<10mL, minshow sufficient T>MIC₉₀ that predict clinical effects without excessive accumulation.<BR>2. For patients with renal impairment managed with hemodialysis modeled as three times a week, CFPM 1g loading dose followed by 0.5g QD dose just after hemodialysis avoids marked T>mIC90 decrease and reaches sufficient T>MIC₉₀ while hemodialysis removes CFPM from blood and rapidly decreases serum concentrations.<BR>3. No dose adjustment in BW from 40 to 90kg is required for patients with renal impairment managed with or without hemodialysis since no remarkable changes in PK profiles and T>MIC. were estimated within the BW range.

収録刊行物

• 日本化学療法学会雑誌

  日本化学療法学会雑誌 53 (5), 302-308, 2005

  公益社団法人 日本化学療法学会

キーワード

• cefepime
• population PK
• renal impairment
• dose

詳細情報

• CRID: 1390282681261228544
• NII論文ID: 130004298254
• NII論文ID: 10015650532
• NII書誌ID: AN10472127
• DOI: 10.11250/chemotherapy1995.53.302
• ISSN: 18845886
• ISSN: 13407007
• Web Site: https://search.jamas.or.jp/link/ui/2005223793
• 本文言語コード: ja
• データソース種別:
  • JaLC
  • CiNii Articles
• 抄録ライセンスフラグ: 使用不可