{"title":"妥布霉素给药期间脐血胱抑素C值的谷值预测。","authors":"Kentaro Hirayama, Arisa Fukui, Tomoya Tsuchihashi, Takayuki Suzuki, Mitsuhiko Riko, Takuya Sugimoto, Takeshi Kumagai, Daisuke Tokuhara","doi":"10.1111/ped.70041","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Therapeutic monitoring is recommended for aminoglycoside drugs, which are often used in neonatal care. In this study, we examined whether it is possible to estimate the trough value after administration using serum creatinine (Cr) and serum cystatin C (CysC) values of umbilical cord artery blood in infants, which can be measured without increasing risks due to invasive tests.</p><p><strong>Methods: </strong>Subjects included infants who were hospitalized between March 2022 and March 2023 and treated with tobramycin (TOB) from 0 days old. In addition to cord blood Cr and CysC, TOB blood concentration (trough value) was measured at 3 days. The correlation coefficient (r) between serum Cr and CysC values and TOB trough value was calculated.</p><p><strong>Results: </strong>Sixteen cases were included in the study. Cord blood Cr and CysC values were divided by gestational week (GW), birth weight (BW), and body surface area (BSA), respectively, and the correlations with TOB trough values were determined. Cord blood CysC/GW/BSA showed a strong correlation with TOB trough value (r = 0.77). The receiver operating characteristic curve for the relationship between cord blood CysC/GW/BSA and TOB trough values ≥1 mg/mL revealed a cut-off value of 0.29 (area under the curve: 0.927, sensitivity: 1.00, specificity: 0.75).</p><p><strong>Conclusion: </strong>Umbilical cord blood CysC/GW/BSA values were strongly correlated with TOB trough values. Cord blood samples can be used to estimate trough values before drug administration without increasing the risk to infants associated with invasive tests, enabling determination of the dosage that will not cause nephrotoxicity.</p>","PeriodicalId":20039,"journal":{"name":"Pediatrics International","volume":"67 1","pages":"e70041"},"PeriodicalIF":1.0000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Trough value prediction using umbilical blood cystatin C value during tobramycin administration.\",\"authors\":\"Kentaro Hirayama, Arisa Fukui, Tomoya Tsuchihashi, Takayuki Suzuki, Mitsuhiko Riko, Takuya Sugimoto, Takeshi Kumagai, Daisuke Tokuhara\",\"doi\":\"10.1111/ped.70041\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Therapeutic monitoring is recommended for aminoglycoside drugs, which are often used in neonatal care. In this study, we examined whether it is possible to estimate the trough value after administration using serum creatinine (Cr) and serum cystatin C (CysC) values of umbilical cord artery blood in infants, which can be measured without increasing risks due to invasive tests.</p><p><strong>Methods: </strong>Subjects included infants who were hospitalized between March 2022 and March 2023 and treated with tobramycin (TOB) from 0 days old. In addition to cord blood Cr and CysC, TOB blood concentration (trough value) was measured at 3 days. The correlation coefficient (r) between serum Cr and CysC values and TOB trough value was calculated.</p><p><strong>Results: </strong>Sixteen cases were included in the study. Cord blood Cr and CysC values were divided by gestational week (GW), birth weight (BW), and body surface area (BSA), respectively, and the correlations with TOB trough values were determined. Cord blood CysC/GW/BSA showed a strong correlation with TOB trough value (r = 0.77). The receiver operating characteristic curve for the relationship between cord blood CysC/GW/BSA and TOB trough values ≥1 mg/mL revealed a cut-off value of 0.29 (area under the curve: 0.927, sensitivity: 1.00, specificity: 0.75).</p><p><strong>Conclusion: </strong>Umbilical cord blood CysC/GW/BSA values were strongly correlated with TOB trough values. Cord blood samples can be used to estimate trough values before drug administration without increasing the risk to infants associated with invasive tests, enabling determination of the dosage that will not cause nephrotoxicity.</p>\",\"PeriodicalId\":20039,\"journal\":{\"name\":\"Pediatrics International\",\"volume\":\"67 1\",\"pages\":\"e70041\"},\"PeriodicalIF\":1.0000,\"publicationDate\":\"2025-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pediatrics International\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/ped.70041\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pediatrics International","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/ped.70041","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PEDIATRICS","Score":null,"Total":0}
Trough value prediction using umbilical blood cystatin C value during tobramycin administration.
Background: Therapeutic monitoring is recommended for aminoglycoside drugs, which are often used in neonatal care. In this study, we examined whether it is possible to estimate the trough value after administration using serum creatinine (Cr) and serum cystatin C (CysC) values of umbilical cord artery blood in infants, which can be measured without increasing risks due to invasive tests.
Methods: Subjects included infants who were hospitalized between March 2022 and March 2023 and treated with tobramycin (TOB) from 0 days old. In addition to cord blood Cr and CysC, TOB blood concentration (trough value) was measured at 3 days. The correlation coefficient (r) between serum Cr and CysC values and TOB trough value was calculated.
Results: Sixteen cases were included in the study. Cord blood Cr and CysC values were divided by gestational week (GW), birth weight (BW), and body surface area (BSA), respectively, and the correlations with TOB trough values were determined. Cord blood CysC/GW/BSA showed a strong correlation with TOB trough value (r = 0.77). The receiver operating characteristic curve for the relationship between cord blood CysC/GW/BSA and TOB trough values ≥1 mg/mL revealed a cut-off value of 0.29 (area under the curve: 0.927, sensitivity: 1.00, specificity: 0.75).
Conclusion: Umbilical cord blood CysC/GW/BSA values were strongly correlated with TOB trough values. Cord blood samples can be used to estimate trough values before drug administration without increasing the risk to infants associated with invasive tests, enabling determination of the dosage that will not cause nephrotoxicity.
期刊介绍：
Publishing articles of scientific excellence in pediatrics and child health delivery, Pediatrics International aims to encourage those involved in the research, practice and delivery of child health to share their experiences, ideas and achievements. Formerly Acta Paediatrica Japonica, the change in name in 1999 to Pediatrics International, reflects the Journal''s international status both in readership and contributions (approximately 45% of articles published are from non-Japanese authors). The Editors continue their strong commitment to the sharing of scientific information for the benefit of children everywhere.
Pediatrics International opens the door to all authors throughout the world. Manuscripts are judged by two experts solely upon the basis of their contribution of original data, original ideas and their presentation.
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