伏立康唑在不同年龄段中国儿童群体中的剂量优化分析  

Analysis of Dose Optimization of Voriconazole in Chinese Children of Different Age Groups

作　　者：杨梦婕[1] 钟文 陈亚静 周密 杨帆[1] 卢俊[1] 王梅 YANG Meng-jie;ZHONG Wen;CHEN Ya-jing;ZHOU Mi;YANG Fan;LU Jun;WANG Mei(Children's Hospital of Soochow University,Suzhou Jiangsu 215000,China)

机构地区：[1]苏州大学附属儿童医院,江苏苏州215000

出　　处：《抗感染药学》2023年第2期133-138,共6页Anti-infection Pharmacy

基　　金：苏州市医疗卫生科技创新关键技术攻关项目(SKY2021049)。

摘　　要：目的:研究伏立康唑针对不同年龄段的中国儿童群体的最优给药剂量,为临床合理用药提供参考。方法:回顾性分析苏州大学附属儿童医院42例不同年龄段患儿使用伏立康唑注射剂(4或7 mg/kg q12h)血清药物谷浓度的达标情况,评估不同年龄段中国儿童的最优伏立康唑给药剂量。结果:在给药剂量相同的情况下,2~<6岁患者伏立康唑谷浓度的中位值均显著低于6~<12岁或12~<18岁患者;6~<12岁与12~<18岁患者的伏立康唑谷浓度经比较其差异无统计学意义;伏立康唑给药剂量为“4 mg/kg,q12h”时,80%的2~<6岁患儿的血清药物谷浓度不能达国际指南推荐的最低目标(1 mg/L),当伏立康唑剂量增加至7 mg/kg,q12h时,该年龄组仅有37.5%的患者不能达到最低目标谷浓度;伏立康唑剂量按“4 mg/kg,q12h”静脉滴注时,72.7%的6~<12岁患儿可达到目标谷浓度,当给药剂量增加至“7 mg/kg,q12h”时,60%的6~<12岁患儿的伏立康唑谷浓度高于指南推荐的最大值5.5mg/L。结论:年龄和给药剂量对中国儿童患者的伏立康唑药物谷浓度均有显著影响,对于2~<6岁的儿童,伏立康唑剂量按“4 mg/kg,q12h”给药时,多数患者不能达到目标谷浓度的最低值;对于6~<12岁儿童,伏立康唑按“7 mg/kg,q12h”的给药剂量偏高,因此“4 mg/kg,q12h”的剂量更推荐作为中国6岁以上儿童患者的适宜剂量。Objective:To investigate the optimal dose of voriconazole for Chinese children of different age groups,so as to provide reference for clinical rational drug use.Methods:A retrospective analysis was conducted on 42 children of different age groups who received voriconazole injections(4 or 7 mg/kg q12h)at Children's Hospital of Soochow University to assess the optimal dose of voriconazole in Chinese children of different age groups.Results:With the same dose,the median trough concentration of voriconazole in patients aged[2,6)was significantly lower than that in patients aged[6,12)or[12,18).There was no significant difference in the trough concentration of voriconazole between the patient groups aged[6,12)and[12,18).When the dose of voriconazole was 4 mg/kg q12h,the serum drug trough concentration of 80%of children aged[2,6)could not reach the minimum target recommended by international guidelines(1 mg/L).When the dose was increased to 7 mg/kg q12h,only 37.5%of patients in this age group could not reach the minimum target trough concentration.Intravenous infusion of 4 mg/kg q12h of voriconazole could achieve the target trough concentration in 72.7%of children aged[6,12).When the dose was increased to 7 mg/kg q12h,60%of children aged[6,12)had a trough concentration of voriconazole higher than the maximum value of 5.5mg/L recommended by guidelines.Conclusion:Age and dose have a significant impact on the trough concentration of voriconazole in Chinese pediatric patients.For children aged[2,6),most patients cannot reach the minimum target trough concentration at a dose of 4 mg/kg q12h of voriconazole.For children aged[6,12),the dose of voriconazole at 7 mg/kg q12h is relatively high,so a dose of 4 mg/kg q12h is more recommended as the appropriate dose for children aged 6 and above in China.

关 键 词：伏立康唑 儿童 不同年龄段 血药谷浓度 

分 类 号：R969.3[医药卫生—药理学]