24广州医药2023年2月第54卷第2期《2022JSC/JSTDM临床实践指南：替考拉宁治疗药物监测》解读王润红河哈尼族彝族自治州中医医院（红河654399）【摘要】目的为临床合理使用替考拉宁以及更好地管理接受替考拉宁治疗的患者。方法从药学角度对2022年日本《2022JSC/JSDM临床实践指南：替考拉宁治疗药物监测》（简称《指南》）涉及替考拉宁治疗的9个临床问题进行解读。结果《指南》指出药-时曲线下面积/最小抑菌求度是替考拉宁的关键药动学/药效学参数。替考拉宁治疗药物监测(TDM)的目的是明确目标谷浓度(C。),对于严重或复杂的耐甲氧西林金黄色葡萄球菌(MRSA)感柒，指南建议替考拉宁Ca为20~40mg/L。肾功能正常或轻度受损的非复杂性的MRSA感柒，目标C。为15~30mgL。严重和/或复杂性MRSA感柒，如感柒性心内膜炎和骨随炎，替考拉宁C。为20~40mgL。结论《指南》针对不同病理状态下患者替考拉宁目标C的确定，为临床治疗中替考拉宁TDM、个体化给药提供参考。【关键词】替考拉宁；治疗药物监测；耐甲氧西林金黄色葡萄球菌；指南解读；目标谷浓度D0I:10.3969/j.isn.1000-8535.2023.02.004Interpretation of Clinical practice guidelines for therapeutic drug monitoring of teicoplanin:a consen-sus review by the Japanese Society of Chemotherapy and the Japanese Society of Therapeutic DrugMonitoringWANG RunHonghe Hani and Yi Autonomous Prefecture Hospital of Traditional Chinese Medicine,Honghe 654399,China[Abstract]Objective To make rational use of teicoplanin and better management of patients treated with teicopla-nin.Methods Nine clinical issues related to the treatment of teicoplanin in Clinical practice guidelines for therapeutic drugmonitoring of teicoplanin:a consensus review by the Japanese Society of Chemotherapy and the Japanese Society of TherapeuticDrug Monitoring (Japan,2022)were interpreted from the perspective of pharmacy.Results The guidelines indicated thatthe area under drug-time curve/minimum inhibitory concentration was the key pharmacokinetic/pharmacodynamic parametersof teicoplanin.The purpose of therapeutic drug monitoring (TDM)of teicoplanin is to specify the target trough concentration(C),which guidelines recommend for severe or complex methicillin-resistant Staphylococcus aureus (MRSA)infection is20-40 mg/L.The target C.for uncomplicated MRSA infection with normal or mildly impaired renal function is 15-30 mg/LFor severe and or complex MRSA infections,such as infective endocarditis and osteomyelitis,the C of teicoplanin was20-40 mg/L.Conclusions The guidelines are aimed at the determination of target C of teicoplanin in patients with differ-ent pathological conditions,and provide reference for individual drug administration and teicoplanin TDM in clinical treat-ment.[Key words]teicoplanin;TDM;MRSA guide interpretation;C替考拉宁是糖肽类抗生素，已被广泛用于治疗Drug Monitoring,JSTDM)共同发布了《2022JSC/包括耐甲氧西林金黄色葡萄球菌(methicillin-reJSTDM临床实践指南：替考拉宁治疗药物监测》。sistant staphylococcus aureus,MRSA)在内的革兰1指南概述阳性菌引起的感染，其与万古霉素比较疗效相当，耐药率低，发生不良事件的风险更低，肾毒性也显该指南根据2017年日本医疗信息分发处出版著降低。替考拉宁与血浆蛋白结合率高，半衰期长的方法手册制定，对循证推荐进行了系统性回顾、达83~163小时，在给药剂量固定时，结合药物代Meta分析和临床研究】，选择9个临床问题谢动力学参数，其实际血药浓度波动很大。为了更(clinical questions,CQs),为MRSA感染患者替考好地管理接受替考拉宁治疗的患者，日本化疗学会拉宁的目标谷浓度(trough concentration,C)确(Japanese Society of Chemotherapy,JSC)和日本治定给出建议。在思维分类中，推荐基于证据的确定疗药物监测学会(Japanese Society of Therapeutic性（强推荐：中等推荐；条件性推荐；不推荐）
