Pharmacokinetic/pharmacodynamic parameters of teicoplanin for predicting clinical outcome of glycopeptide-susceptible Enterococcus faecium bacteraemia.

IF 3.3 Q2 INFECTIOUS DISEASES
JAC-Antimicrobial Resistance Pub Date : 2025-08-21 eCollection Date: 2025-08-01 DOI:10.1093/jacamr/dlaf151
Ryo Yamaguchi, Takehito Yamamoto, Sohei Harada, Mayu Shibuya, Miyuki Mizoguchi, Yoshimi Higurashi, Miho Echizenya, Takeya Tsutsumi, Tappei Takada
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引用次数: 0

Abstract

Objectives: The objective of this study was to determine the pharmacokinetic/pharmacodynamic parameters of teicoplanin associated with optimal outcomes in glycopeptide-susceptible Enterococcus faecium (GSEF) bacteraemia.

Patients and methods: We conducted a retrospective review of GSEF bacteraemia cases treated with teicoplanin between 1 April 2009 and 30 May 2023. Total area under the concentration-time curve over 24 h (AUC24) was calculated using a Bayesian approach. The free AUC24 (fAUC24) was estimated based on patient serum albumin levels. MICs were determined using the gradient diffusion method (Etest), and the fAUC24/MICEtest ratio was calculated. The primary outcome was treatment failure, defined as a composite of (i) 30-day all-cause mortality and (ii) microbiological failure, defined as persistent bacteraemia (a positive follow-up blood culture obtained >72 h after initiation of appropriate therapy). Classification and regression tree analysis (CART) was employed to identify the optimal teicoplanin fAUC24/MICEtest value associated with treatment failure.

Results: A total of 76 patients were included. Treatment failure occurred in 18 patients (23.7%). A CART-derived teicoplanin fAUC24/MICEtest ≥ 462 was significantly associated with reduced treatment failure (P = 0.002). Multivariable regression analysis revealed that achievement of an fAUC24/MICEtest ≥ 462 was an independent predictor significantly associated with reduced treatment failure (OR, 0.099; 95% CI, 0.005-0.562; P = 0.032).

Conclusions: An fAUC24/MICEtest ≥ 462 was associated with a reduction in treatment failure in GSEF bacteraemia. Further studies are necessary to establish optimal pharmacokinetic/pharmacodynamic targets for GSEF bacteraemia.

Abstract Image

Abstract Image

替柯planin的药代动力学/药效学参数预测糖肽敏感屎肠球菌菌血症的临床结局。
目的:本研究的目的是确定与糖肽敏感屎肠球菌(GSEF)菌血症的最佳结果相关的替柯planin的药代动力学/药效学参数。患者和方法:我们对2009年4月1日至2023年5月30日期间使用替柯planin治疗的GSEF菌血症病例进行了回顾性分析。采用贝叶斯方法计算24 h浓度-时间曲线下的总面积(AUC24)。根据患者血清白蛋白水平估计游离AUC24 (fAUC24)。采用梯度扩散法(Etest)测定MICs,计算fAUC24/MICEtest比值。主要终点是治疗失败,定义为(i) 30天全因死亡率和(ii)微生物学失败,定义为持续性菌血症(开始适当治疗后72小时随访血培养呈阳性)。采用分类回归树分析(CART)确定与治疗失败相关的替可普兰蛋白最优fAUC24/MICEtest值。结果:共纳入76例患者。治疗失败18例(23.7%)。cart衍生的teicoplanin fAUC24/MICEtest≥462与减少治疗失败显著相关(P = 0.002)。多变量回归分析显示,达到fAUC24/MICEtest≥462是减少治疗失败的独立预测因子(OR, 0.099; 95% CI, 0.005-0.562; P = 0.032)。结论:fAUC24/MICEtest≥462与GSEF菌血症治疗失败的减少相关。需要进一步研究以确定GSEF菌血症的最佳药代动力学/药效学靶点。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
5.30
自引率
0.00%
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0
审稿时长
16 weeks
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