Vankomütsiini AUC₂₄ sihtvahemiku saavutamine ja seda mõjutavad tegurid
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Autorid
Ajakirja pealkiri
Ajakirja ISSN
Köite pealkiri
Kirjastaja
Tartu Ülikool
Abstrakt
Vankomütsiini annustamine on keeruline, kuna ravimi toime ja kõrvaltoime te risk sõltuvad patsiendi ravimiekspositsioonist. Bakalaureusetöö eesmärk oli hinnata vankomütsiini terapeutilise vahemiku saavutamist Tartu Ülikooli Kliinikumi intensiivraviosakondade patsientidel ning uurida, millised tegurid on seotud sihtvahemiku saavutamisega.
Töös kasutati prospektiivse kliinilise uuringu ProVanc (EUCT number: 2023-509003-32-00) andmestikku, mis sisaldas 59 patsiendi korduvmõõtmisi. Esmalt anti ülevaade vankomütsiini kasutamisest, AUC₂₄ tähendusest ja töös kasutatud statistilisest metoodikast. Praktilises osas kirjeldati kasutatud and mestikku ja hinnati sihtvahemiku saavutamisega seotud tegureid, kasutades juhuslike mõjudega logistilist regressioonmudelit.
Tulemused näitasid, et vankomütsiini terapeutilise vahemiku saavutamise tõenäosus suurenes ravi kestuse pikenedes. Mudeli põhjal oli sihtvahemiku saavutamine seotud ka doosi optimeerimisega. Kliinilistest tunnustest osutus oluliseks mehaanilise ventilatsiooni kasutamine.
Vancomycin dosing is challenging because its efficacy and risk of adverse effects depend on the patient’s drug exposure. The aim of this Bachelor thesis was to assess attainment of the therapeutic vancomycin target range in patients treated in the intensive care units of Tartu University Hospital and to identify associated factors. The study used data from the prospective clinical study ProVanc (EUCT number: 2023-509003-32-00), which contained repeated measurements from 59 patients. The first part of the thesis gives an overview of vancomycin use, the meaning of AUC₂₄ and the statistical methodology used in the analysis. In the analysis section, the dataset is described and a generalized linear mixed-effects logistic regression model is used to assess factors related to target attainment. The results showed that the probability of attaining the vancomycin target range increased with treatment duration. Target attainment was also associated with dose optimisation. Among clinical variables, the use of mechanical ventilation was identified as an important factor.
Vancomycin dosing is challenging because its efficacy and risk of adverse effects depend on the patient’s drug exposure. The aim of this Bachelor thesis was to assess attainment of the therapeutic vancomycin target range in patients treated in the intensive care units of Tartu University Hospital and to identify associated factors. The study used data from the prospective clinical study ProVanc (EUCT number: 2023-509003-32-00), which contained repeated measurements from 59 patients. The first part of the thesis gives an overview of vancomycin use, the meaning of AUC₂₄ and the statistical methodology used in the analysis. In the analysis section, the dataset is described and a generalized linear mixed-effects logistic regression model is used to assess factors related to target attainment. The results showed that the probability of attaining the vancomycin target range increased with treatment duration. Target attainment was also associated with dose optimisation. Among clinical variables, the use of mechanical ventilation was identified as an important factor.
Kirjeldus
Märksõnad
vankomütsiin, kliiniline uuring, statistika, vancomycin, clinical trial, statistics