เภสัชจลนศาสตร์ของยา ertapenem ในผู้ป่วย urosepsis จากเชื้อ enterobacteriaceae ที่ผลิตเอนไซม์ Extended spectrum B-lactamase (ESBL)

Abstract

At present, the mortality rate of uroseptic patients has been increasing due to antibiotic resistant strain especially, Enterobacteriaceae producing extended-spectrum Blactamases (ESBLs). This enzyme inhibits many antibiotic groups except carbepenems. Ertapenem has been considered as the first line drug effective against ESBLS-producing gram-negative bacteria infection. Therefore, this study aim to investigate the pharmacokinetics of ertapenem in patients with urosepsis caused by ESBLs producing Enterobacteriaceae. Plasma ertapenem analysis was determined by reverse-phase high performance liquid chromatography (RP-HPLC) with ultraviolet detection. Plasma sample was non-protein bound fraction by ultrafiltration technique. Eight patients with urosepsis received 1 gram/day of ertapenem intravenous over 30 minutes continuously, then plasma was collected at 0, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12 and 24 hours. The results have shown that the maximum plasma concentration (C) was 19.52 + 10.42 ug/mL, the area under the concentration-time curve between zero to 24 hours (AUC -2.) values was 91.50 + 71.38 ugoh/mL, the area under the concentration-time curve between zero to infinity (AUC ) values was 100.13 + 78.14 ug•h/mL, the volume at steady state (V..) values was 170.61 = 162.34 L, the clearance (CL) was 15.84 + 10.02 L/h and the half-life (T ) values was 7.12 + 3.21 h. These data could be beneficial information for ertapenem dosing adjustment in the future.