| 摘要: |
| 目的:应用蒙特卡洛模拟法,评价米卡芬净2 种给药方案治疗婴幼儿念珠菌感染的疗效。方法:结合米卡芬净在婴幼儿
患者中的药动学(PK)参数和药效学(PD)数据,以游离药物分数的药时曲线下面积与最低抑菌浓度的比值(f AUC/ MIC) 为米
卡芬净的PK/ PD 模型,采用蒙特卡洛模拟法运行10 000 次,计算米卡芬净不同给药方案对3 种念珠菌的达标概率(PTA)和累
积反应分数(CFR),比较得出最优给药方案。结果:在婴幼儿感染患者中,米卡芬净2 种给药方案治疗3 种念珠菌感染的PTA
和CFR 不同。对于白色念珠菌、光滑念珠菌,4. 5 mg/ (kg·d)给药方案可达到CFR>90%,然而2 种给药方案治疗近平滑念珠
菌感染均未达到CFR>90%。结论:米卡芬净治疗白色念珠菌、光滑念珠菌引起的婴幼儿侵袭性感染时,可采用4.5 mg/ (kg·d)给药
方案;对于近平滑念珠菌引起的感染,建议更换药物或进行药物联合治疗。 |
| 关键词: 米卡芬净 婴幼儿 药动学 给药方案 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2025.10.011 |
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| 基金项目: |
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| Optimal Clinical Treatment Regimens of Micafungin in Infants with Candida Infection Based onPharmacokinetic and Pharmacodynamic Parameters |
| Sha Sha1, Pan Yue2, Ge Tingyue3 |
| ((1. Baoding Hospital, Beijing Children’s Hospital, Capital Medical University, Hebei Baoding
071000, China; 2. Kangda College, Nanjing Medical University, Jiangsu Lianyungang 222061, China; 3. Children’ s Hospital
Affiliated to Nanjing Medical University, Nanjing 210000)) |
| Abstract: |
| Objective: To estimate two dosage regimens of micafungin in the treatment of Candida infection in infants with Monte Carlo
simulation. Methods: Pharmacokinetic (PK) and pharmacodynamic (PD) parameters of micafungin in infants were integrated, with
the area under the free drug concentration-time curve/ minimum inhibitory concentration (f AUC/ MIC) serving as the PK/ PD index.
Monte Carlo simulation was performed for 10,000 times to calculate the probability of target attainment (PTA) and cumulative fractions
of response (CFR) for different dosage regimens of micafungin against three kinds of Candida. The optimal dosage regimen was
determined by comparative analysis. Results: In infants with infection, the two dosage regimens of micafungin showed different PTA and
CFR values for the three kinds of Candida infections. The dosage regimen of 4. 5 mg/ (kg·d) demonstrated optimal CFR values (>90%) against Candida albicans and Candida glabrata. However, neither of the two dosage regimens reached CFR >90% for Candida
parapsilosis. Conclusion: For invasive infection induced by C. albicans and C. glabrata, dosage of 4. 5 mg/ (kg·d) of micafungin was
recommended. For C. parapsilosis, alternative antifungal regimens or combination therapy should be considered. |
| Key words: micafungin infants pharmacokinetics dosage regimens |
