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中国临床药理学与治疗学 ›› 2021, Vol. 26 ›› Issue (1): 30-39.doi: 10.12092/j.issn.1009-2501.2021.01.005

• 定量药理学 • 上一篇    下一篇

基于群体药动学模型的万古霉素个体化给药软件研制及应用

郭仙忠,林荣芳,林玮玮   

  1. 福建医科大学附属第一医院药学部,福州 350005,福建
  • 收稿日期:2020-05-26 修回日期:2020-10-07 出版日期:2021-01-26 发布日期:2021-02-01
  • 通讯作者: 林玮玮,男,博士,副主任药师,研究方向:临床药学。 Tel: 13705063157 E-mail: 372447583@qq.com
  • 作者简介:郭仙忠,男,硕士,主管药师,研究方向:临床药学。 Tel: 13763899454 E-mail: 9477101@qq.com
  • 基金资助:
    福建省科技厅引导性项目(2017Y0033);福建医科大学启航基金(2017XQ1068)

Development of software for individualizing dosage regimens of vancomycin based on population pharmacokinetics models

GUO Xianzhong, LIN Rongfang, LIN Weiwei   

  1. Pharmacy Department of First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, Fujian, China
  • Received:2020-05-26 Revised:2020-10-07 Online:2021-01-26 Published:2021-02-01

摘要: 目的:研发基于建立的成人和老年群体药动学(population pharmacokinetics, PPK)模型的万古霉素(vancomycin, VCM)个体化给药软件。方法:根据已建立的成人和老年VCM的PPK模型信息,运用MyEclipse、SQL Server、JRE等工具软件研发VCM给药软件。软件开发方案包括需求分析,概要设计,详细设计,软件编码,软件测试以及软件维护和二次开发。结果:研制的VCM给药软件可实现感染患者信息输入和管理,软件通过接口调用非线性混合效应模型(NONMEM)软件,不仅能预测多种具体VCM给药方案下的血药浓度,供临床医师制定初始用药方案参考,而且能结合已有的血药浓度监测信息和贝叶斯反馈法更精准地预测血药浓度,辅助临床医师进一步优化给药方案。软件应用于VCM血药浓度解读,药师向临床做出剂量调整建议。采纳建议组患者复查的血药浓度均达到目标血药浓度范围。结论:本研究基于VCM的PPK模型研制的给药软件能快速方便地辅助成人和老年感染患者VCM的个体化给药。

关键词: 万古霉素, 群体药动学, 个体化给药, 给药软件

Abstract: AIM: To develop software for individualizing dosage regimens of vancomycin (VCM) according to the established population pharmacokinetics (PPK) models.  METHODS: VCM dosing software was developed using MyEclipse, SQL Server, and JRE. The software developing schemes included requirement analysis, general design, detailed design, software coding, software test, software maintenance and software redevelopment. RESULTS: The developed software achieved the functions such as input and management of patient information, prediction of trough concentrations under various dosing regimens which could help initial dosage design, and prediction of trough concentrations more accurately based on therapeutic drug monitoring results and Bayesian method which could help dosage adjustment. The software was utilized in the interpretation of VCM serum concentration, pharmacists proposed the suggestions for adjusting dosage regimens. The rechecked serum concentrations all reached the expected target blood concentration range in the group of adopting advice. CONCLUSION: The new developed software based on our established PPK models can provide a useful tool in the clinical setting to facilitate the individualized therapy for the adult and elderly infected patients.

Key words: vancomycin, population pharmacokinetics, dose individualization, dosing software

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