医療薬学
Online ISSN : 1882-1499
Print ISSN : 1346-342X
ISSN-L : 1346-342X
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テイコプラニン初回投与設計における血中濃度予測の検討
−性別,年齢別,血清クレアチニン値補正,体格補正,eGFR推算式による影響−
小曳 恵里子佐藤 智昭上島 智黒田 真生沖野 真季大西 和也河崎 陽一名倉 弘哲松永 尚千堂 年昭
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2012 年 38 巻 7 号 p. 461-470

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The dosing regimen of teicoplanin (TEIC) is primarily determined by a patient's renal function. Currently, CockcroftGault (CG) equation is widely used to evaluate renal function; however, a new equation for estimation of the glometer filtration rate (eGFR) was reported by the Japanese Society of Nephrology in 2008. Accumulated evidence-from recent studies suggests that correction of the serum creatinine (SCr) and physical constitutions of the pyknic body type (body mass index (BMI) ≥ 25) provides a better predictive outcome for setting the initial dosing of vancomycin. We investigated the influence of gender and age and the effect of correcting the SCr and physical constitutions parameters on the initial dosing of TEIC in conjunction with either the eGFR equation or the CG equation. As a result of this analysis, for patients under age 65 and for women, the prediction error (PE) of the eGFR equation was found to be significantly improved compared with the PE of the CG equation. By correction of the SCr, the PE of both the CG and eGFR equations was significantly improved, and by correction of the physical constitutions, the PE of the eGFR equation was significantly improved. Therefore, these results suggest that the eGFR equation would be more useful for determining the initial dose of TEIC for patients under age 65 and for female patients, and moreover, further improvements could be obtained by correction of the SCr and the physical constitutions of the pyknic body type (BMI≥25) with the eGFR equation to determine the initial dosing of TEIC.
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© 2012 日本医療薬学会
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