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논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2020.1
- 수록면
- 516 - 529 (14page)
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Background: Infections by Carbapenem-Resistant Enterobacteriaceae (CRE) remain a leading cause of death in critically ill patients. Fosfomycin has been regarded as an alternative therapy for treatment of infections caused by CRE organisms. The purpose of this study is to evaluate clinical outcomes amongst patients with CRE infection who are receiving a fosfomycin dosing regimen using a Monte Carlo simulation and fosfomycin minimum inhibitory concentration (MIC). Materials and Methods: Fosfomycin MIC was defined by the E-test method. We used Fosfomycin pharmacokinetic parameters from a previously published study. The percent of the time period in which the drug concentration exceeded the MIC, or %T>MIC, used in this study were determined to be 70% of T>MIC and 100% of T>MIC, respectively. All dosing regimens were estimated for the probability of target attainment using a Monte Carlo simulation. Results: In this study, we found the MIC's of fosfomycin against CRE isolates ranged from 8 mg/L to 96 mg/L. The total daily dose of fosfomycin ranged from 16 - 24 g and was administered utilizing various fosfomycin dosing regimens to achieve the pharmacokinetic/ pharmacodynamic (PK/PD) target in pathogens with a MIC of 32 mg/L for 70%T>MIC and a MIC of 12 mg/L for 100%T>MIC, respectively. For the twelve patients who received the recommended fosfomycin dosing regimen, eleven achieved bacterial eradication for a microbiological cure rate of 91%; and of those patients achieving eradication, two died despite having negative cultures for CRE; the one remaining patient had bacterial persistence. The most commonly observed adverse drug reactions were hypernatremia (3 cases) and hypokalemia (3 cases) and acute kidney injury (3 cases). Conclusion: Our findings suggest fosfomycin has tended to good efficacy when using dosing regimens that achieve the PK/PD target. Nonetheless, further validation of these regimens in larger populations is needed.
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참고문헌 (41)
참고문헌 신청
Codjoe FS / 2017 / Carbapenem resistance: a review / Med Sci(Basel) 6:1
The National Antimicrobial Resistance Surveillance Thailand (NARST) / The situation of antimicrobial resistance in health service areas from January to June 2019
Ting SW / 2018 / Risk factors and outcomes for the acquisition of carbapenem-resistant Gramnegative bacillus bacteremia : A retrospective propensity-matched case control study / J Microbiol Immunol Infect 51:621~628
Tamma PD / 2018 / Phenotypic detection of carbapenemase-producing organisms from clinical isolates / J Clin Microbiol 56:e01140~e01218
Sheu CC / 2019 / Infections caused by carbapenem-resistant Enterobacteriaceae : An update on therapeutic options / Front Microbiol 10:1~13
The National Antimicrobial Resistance Surveillance Thailand (NARST) / The situation of antimicrobial resistance in health service areas from January to June 2019
Ting SW / 2018 / Risk factors and outcomes for the acquisition of carbapenem-resistant Gramnegative bacillus bacteremia : A retrospective propensity-matched case control study / J Microbiol Immunol Infect 51:621~628
Tamma PD / 2018 / Phenotypic detection of carbapenemase-producing organisms from clinical isolates / J Clin Microbiol 56:e01140~e01218
Sheu CC / 2019 / Infections caused by carbapenem-resistant Enterobacteriaceae : An update on therapeutic options / Front Microbiol 10:1~13
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