Colimycin_2MU.jpg 
由於colimycin在臨床上,劑量和以往熟知的抗生素有所不同,所以節錄文獻於下
 

RENAL FUNCTION

Degree of impairment

Degree of Impairment

Normal

Mild

Moderate

Considerable

Plasma creatinine (mg/ 100 mL)

0.7-1.2

1.3-1.5

1.6-2.5

2.6-4.0

Urea clearance (% normal)

80-100

40-70

25-40

10-25

Dosage

Unit dose (mg)

100-150

75 to 115

66 to 150

100 to 150

Doses/ day

2-4

2

2 or 1

Every 36 hr

Total Daily Dose (mg/day)

300

150 to 230

133 to 150

100

Approximate Daily Dose (mg/kg/day)

5.0

2.5 to 3.8

2.5

1.5

Note: The suggested unit dose is 2.5 to 5 milligrams/kilogram; however, the time INTERVAL between injections should be increased in the presence of impaired renal function.

 

肌肉注射:

腎功能正常者:2.5-5mg/kg/day,分成2-4

以注射用滅菌水或生理食鹽水2mL稀釋,濃度為33.4mg/mL

體重50 kg的病患,給藥劑量為:125~250mg/day31.25~62.5mg bid),等於0.5~1vial q12h

靜脈注射:

一次為半日劑量,給藥時間要超過5分鐘,每12小時一次。

 

 

Dosage Adjustment During Dialysis

Continuous Venovenous Hemodiafiltration

1)  When colistin methanesulfonate (CMS) 150 milligrams every 48 hours was administered intravenously to a 53-year-old woman (total body weight, 100 kilograms (kg); ideal body weight, 61 kg) with bowel perforation leading to multiple organ failure which required continuous venovenous hemodiafiltration (CVVHDF), the maximum plasma concentration of CMS and colistin was less than 16 x MIC and less than 2 x MIC against Pseudomonas aeruginosa, respectively, and the plasma concentrations of CMS and colistin fell below their respective MICs approximately 4 hours after CMS administration and remained so for most of the 48-hour dosing interval. The authors suggest a more modest dosage adjustment for CMS in patients requiring CVVHDF, such as 2 to 3 milligrams/kilogram (mg/kg) every 12 hours, rather than the regimen used in this case (2.46 mg/kg of ideal body weight every 24 hours) (Li et al, 2005).

 特別注意的是,如果洗腎患者,洗腎前已經給藥,需要再洗腎後補打一劑,否則可以選擇在洗腎後給藥


臨床Colistin吸入給藥劑量調整

吸入給藥盡量不要超過3天,不過臨床上建議可以延長到1 個禮拜。

配製:先以Dis. water 泡製成2mL,吸入給藥時再用NS調整為46mL

體重

劑量

頻率

備註

40kg

80mg

Q12h

亞洲人

40kg

40mg

Q12h

 

Colistin 66.8mg吸入給藥時劑量調整

體重

劑量

頻率

40kg

0.5 vial

Q12h

40kg

0.25 vial

Q12h

如果復發,則改為160mg q8h(就是1vial q8h)

 
2009/01/22修改三版
arrow
arrow
    全站熱搜

    快樂小藥師 發表在 痞客邦 留言(5) 人氣()