OncohematologyOncohematologyОнкогематология1818-83462413-4023Publishing House ABV Press11510.17650/1818-8346-2014-9-2-53-57PHARMACOTHERAPYФАРМАКОТЕРАПИЯColistine pharmacokinetics and Colistimethate sodium daily dose calculation in children with chemotherapy induced neutropeniaФармакокинетика колистина и расчет суточной дозы колистиметата натрия у детей с химиоиндуцированной нейтропениейZakharevichV. I.ЗахаревичВ. И.
Russian Federation
DmitrievV. V.ДмитриевВ. В.
Russian Federation
dmitrievhaematol@mail.ruRepublican Scientific Centеr of Pediatric Oncology, Hematology and Immunology, Ministry of Health of Republic of Belarus, MinskГУ РНПЦ ДОГИ Министерства здравоохранения Республики Беларусь, Минск170920149253571709201417092014https://oncohematology.abvpress.ru/ongm/article/view/115

A standard fractional Colistimethate sodium dosing regimen does not allow in most cases reach the target values of AUC / MIC index, determining the Colistine pharmacological efficacy. Use of the proposed algorithm for daily dose calculating increases the incidence to achieve Colistine concentration providing AUC values, sufficient for A. baumannii, P. aeruginosa and K. pneumoniae with Colistine MIC0.75–1 mg / l. Using fractional administration of recommended daily dose target AUC values for MIC 1 g / l achieved only in 19 % cases,whereas using the proposed algorithm of intravenous injection with long-time constant rate of daily dose 100.000 ME / kg Colistimethatesodium – in 60 % (in 3 of 5 patients).

Применение стандартного фракционного режима введения колистиметата натрия не позволяет в большинстве случаев достичь целевых значений индекса площадь под фармакокинетической кривой / минимальная ингибирующая концентрация (AUC / MIC), определяющих фармакологическую эффективность колистина. Использование предлагаемого алгоритма расчета суточной дозы колистиметата натрия увеличивает частоту достижения концентрации колистина, обеспечивающей значения AUC, достаточных для изолятов A. baumannii, P. aeruginosa и K. pneumoniae, имеющих MIC колистина 0,75–1 мг / л. При фракционном режиме введения рекомендуемой инструкцией суточной дозы целевые значения AUC для MIC 1 г / л достигались лишь в 19 % случаев, при использовании предлагаемого алгоритма внутривенного введения с постоянной скоростью в течение длительного времени суточной дозы колистиметата натрия 100 000 МЕ / кг – в 60 % (у 3 из 5 пациентов).

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