先天性巨细胞病毒治疗及双胎早产儿更昔洛韦治疗药物监测。

Q2 Medicine
Pierre-Philippe Piché-Renaud, Charles-Olivier Chiasson, Julie Autmizguine, Philippe Ovetchkine, Christian Lachance, Yves Théorêt, Brigitte Martin
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引用次数: 0

摘要

先天性获得性巨细胞病毒(CMV)感染是世界上最常见的先天性感染,也是获得性感音神经性听力损失的最常见原因。这种疾病的负担在早产儿和极低出生体重婴儿中更为严重。然而,在这些易感人群中,静脉注射更昔洛韦和口服缬更昔洛韦治疗的数据很少。我们报告双胞胎先天性感染巨细胞病毒和早产在妊娠27周的情况下。治疗方案最初根据早产儿和肾功能进行个体化,然后通过治疗药物监测(TDM)进行调整,以适应他们不断发展的生理成熟。随着婴儿年龄的增长,更昔洛韦的血浆半衰期在足月龄10周左右或经后年龄37周左右缓慢下降至足月婴儿值。血液聚合酶链反应试验结果为阴性,长期随访均令人满意。妊娠32周前出生或小于1200g的婴儿的有限数据以及更昔洛韦药代动力学参数的演变证明在这些情况下使用TDM是合理的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Treatment of Congenital Cytomegalovirus and Ganciclovir Therapeutic Drug Monitoring in Twin Preterm Infants.

Congenitally acquired cytomegalovirus (CMV) infection is the most prevalent congenital infection worldwide and the most frequent cause of acquired sensorineural hearing loss. The burden of the disease is even more important in premature and very low birth weight infants. However, few data exist on the treatment with intravenous ganciclovir and oral valganciclovir in this vulnerable population. We report the case of twins congenitally infected with CMV and born prematurely at 27 weeks' gestation. Treatment regimens were initially individualized for their prematurity and renal function, and then adjusted with therapeutic drug monitoring (TDM) to adapt to their continuously evolving physiologic maturation. As infants were aging, the plasmatic half-life of ganciclovir slowly decreased to term infant values around 10 weeks of chronological age, or 37 weeks of postmenstrual age. Results for blood polymerase chain reaction tests became negative and long-term follow-ups were satisfactory in both twins. The limited data for infants born before 32 weeks of gestation or at less than 1200 g and evolution of ganciclovir pharmacokinetic parameters justify the use of TDM in these settings.

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来源期刊
Journal of Pediatric Pharmacology and Therapeutics
Journal of Pediatric Pharmacology and Therapeutics Medicine-Pediatrics, Perinatology and Child Health
CiteScore
2.40
自引率
0.00%
发文量
90
期刊介绍: The Journal of Pediatric Pharmacology and Therapeutics is the official journal of the Pediatric Pharmacy Advocacy Group. JPPT is a peer-reviewed multi disciplinary journal that is devoted to promoting the safe and effective use of medications in infants and children. To this end, the journal publishes practical information for all practitioners who provide care to pediatric patients. Each issue includes review articles, original clinical investigations, case reports, editorials, and other information relevant to pediatric medication therapy. The Journal focuses all work on issues related to the practice of pediatric pharmacology and therapeutics. The scope of content includes pharmacotherapy, extemporaneous compounding, dosing, methods of medication administration, medication error prevention, and legislative issues. The Journal will contain original research, review articles, short subjects, case reports, clinical investigations, editorials, and news from such organizations as the Pediatric Pharmacy Advocacy Group, the FDA, the American Academy of Pediatrics, the American Society of Health-System Pharmacists, and so on.
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