著者

山下 良子 神山 秀一 山本 明日香 加納 宏樹 結城 祥充 上田 晃 川本 由加里 後藤 仁和 山本 聡

出版者

公益社団法人 日本薬学会

雑誌

YAKUGAKU ZASSHI (ISSN:00316903)

巻号頁・発行日

vol.136, no.12, pp.1641-1649, 2016 (Released:2016-12-01)

参考文献数

28

被引用文献数

6

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The efficacy of cefepime (CFPM) is known to depend on the ratio of the time that the serum levels exceed the minimum inhibitory concentration (MIC) to the dosing interval (%T>MIC). The objective of this study was to clarify the relation between %T>MIC and clinical outcome of CFPM, and to identify the optimal dosage regimen. We investigated the outcome of CFPM treatment for febrile neutropenia (FN) patients with normal renal function. Treatment success was defined as the completion of FN therapy with CFPM only. And we calculated %T>MIC for each case based on population pharmacokinetic parameters. The MIC value for simulation was set as 8 μg/mL. In logistic regression analysis, treatment success was significantly associated with the elevation of %T>MIC in the group with persistent neutropenia, yielding a receiver operating characteristic curve with an optimal cutoff value of 73.1%. Next, we simulated %T>MIC for each case under various dosing regimens. For patients whose creatinine clearance (CLcr) exceeded 100 mL/min, it was found to be difficult to attain the objective under the current regimen. In contrast, it was calculated that treatment with 2 g three times a day (t.i.d.) could attain the objective for most of the patients with 3 h of infusion. These results suggest that CFPM treatment under the current regimen is ineffective for FN patients with normal or augmented renal function, and that 2 g t.i.d. is necessary in quite a lot cases, although such use is off-label.

著者

結城 祥

出版者

日本マーケティング学会

雑誌

マーケティングジャーナル (ISSN:03897265)

巻号頁・発行日

vol.39, no.4, pp.66-76, 2020-03-31 (Released:2020-03-31)

参考文献数

26

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わが国のアパレル業界においては,需要不確実性と在庫リスクを吸収すべく,期中生産・期中企画(シーズン中の追加的な発注・企画)が推進されている。果たして,こうした取り組みは不良在庫の削減に寄与しているのであろうか。この問いに実証的な回答を与えることが,本論の目的である。アパレル・メーカーから得られたサーベイ・データを分析した結果,①期中生産は不良在庫の削減に貢献すること,②期中企画は,小売段階を外部化した状況でそれを実施すると不良在庫が増大し,小売段階の一部あるいは全てを統合している場合でも在庫削減効果を持たないことが見出された。期中企画を実施する際には,小売段階をどの程度コントロール可能か,追加企画製品の生産・発注量の意思決定精度を高水準に保つ能力が備わっているか,という点に留意する必要がある。

著者

辻本 高志 和田 吉生 阿知波 一人 結城 祥充 後藤 仁和 福澤 信之 原田 浩

出版者

一般社団法人日本医療薬学会

雑誌

医療薬学 (ISSN:1346342X)

巻号頁・発行日

vol.43, no.8, pp.407-416, 2017-08-10 (Released:2018-08-10)

参考文献数

22

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Although some have reported that Astragali Radix, which has a diuretic effect and is contained in herbal preparations for kidney disorders, suppresses the progress of renal dysfunction, its effects on chronic-phase patients after renal transplantation have not been verified. Therefore, the effect of Astragali Radix on improving the creatinine levels of patients with chronic kidney allograft dysfunction (CKAD) and the possibility of its interaction with immunosuppressants were studied. The subjects were 13 patients who had received living-donor kidney transplantation at our hospital for stage 4/5 chronic kidney diseases (CKD) and agreed to cooperate in the study. Their serum creatinine (sCr) level, which was 3.6 ± 0.8 mg/dL before Astragali Radix administration, decreased significantly by 1 month later and was 3.0 ± 0.7 mg/dL after 3 months, resulting in a significantly increased estimated glomerular filtration rate (eGFR). In all cases, the 1/sCr level after Astragali Radix administration exceeded the value estimated from the approximate line obtained by plotting the pre-administration 1/sCr levels on the administration period. The area under the curve (AUC) of blood concentration standardized by dose for 12 hours after immunosuppressant administration increased by approximately 20% for tacrolimus (TAC) after Astragali Radix administration, but did not change significantly for mycophenolic acid (MPA), which is an active metabolite of mycophenolate mofetil (MMF). Astragali Radix reduced sCr significantly and suppressed the progress of CKAD. Since the blood TAC level increase caused by Astragali Radix was not clinically significant, it was considered safe for use in combination with TAC or MMF.