ABSTRACT
AIM: To study the effects of augmented renal clearance (ARC) on vancomycin pharmacokinetics, efficacy, and safety in patients with infective endocarditis, so as to provide better guidance for vancomycin medication. METHODS: The retrospective analysis was conducted. Patients data from the hospital medical record system from April 2020 to April 2023 during the cardiovascular surgery with use of vancomycin were collected. The subjects were divided into normal group and ARC group according to glomerular filtration rate (eGFR). According to the population pharmacokinetic model, the measured trough concentration was used for a Bayesian approach to estimate individual pharmacokinetic parameters and analyze influence of ARC on vancomycin pharmacokinetics. RESULTS: A total of 163 patients were included in this study. The incidence of ARC was 23.31%. The age of patients in ARC group was significantly lower than that in normal group (P<0.05). Moreover, the steady-state trough concentration (Cmin), trough concentration compliance rate, area under the curve (AUC), and elimination half life (t1/2) were significantly lower in ARC group than that in normal group (P<0.05). In addition, ARC group had significantly higher clearance (CL) and elimination rate than normal group (P<0.05). Correlation analysis showed that Cmin was positively correlated with AUC (r
ABSTRACT
Objective To investigate the outcome of high-risk acute non-lymphocytic leukemia treated with sequential low-dose cytarabine and harringtonine(LD-HA) and standard induction. Methods 50 high-risk ANLL. patients (LD-HA group) who were regarded as unfit for intensive chemotherapy were chosen to receive LD-HA. Reinductive treatments with standard regimens would be given for those who did not achieve complete remission. 23 patients DA/HA group given two cycles of standard inductive regimens were taken as the control. Results In LD-HA group 80.0 %. (40/50) reached CR, 2 patients died shortly after inductive therapy. The median leukemia-free survival(LFS) was 19.6 months, and the median overall survival (OS) was 12.2 months. Overall survival was 57.0 % at 1 year, 24.1% at 3 years, and 18.8 % at 5 years. While the CR rate was 73.9 % for DA/HA group, and none died during the inductive therapy. LFS and OS was 19.8 months and 12.1 months, respectively. OS rate was 56.58 % at 1 year, 27.1% at 3 years, and 27.1% at 5 years.There were no difference on OS rates between 2 groups (x2 were 0.009, 0.237 and 1.807, respectively,P ＞0.05). Conclusion In patients who were unfit for intensive chemotherapy, sequential therapy with LD-HA and standard induction improved the rate of complete remission and the duration of survival.