Investigating the efficacy of insert nanofibers containing Vancomycin and Amikacin in patients with infectious keratitis: A phase I randomized clinical trial (RCT) study

开始日期2024-05-21

申办/合作机构

Kermanshah University of Medical Sciences

NCT05555303 / Recruiting临床2期IIT

Preventing Acquired Resistance: Strengthen TB Treatment by Adding Amikacin in the First Treatment Week of Multidrug-resistant Tuberculosis (Stake) Amendment to Study Protocol: "All-oral Shorter Treatment Regimen for Multidrug- and Rifampicin-resistant Tuberculosis (MDR/RR-TB): Evaluating Its Effectiveness, Safety and Impact on the Quality of Life of Patients in Rwanda" (ShORRT)

Acquired drug-resistance is a major challenge for tuberculosis (TB) care programs. The 2020 WHO guidelines recommends replacing second-line injectables by bedaquiline in rifampicin-resistant TB (RR-TB) treatment regimens. However, recent reports show too high rates of acquired bedaquiline resistance. This may be explained by the delayed onset of action of bedaquiline. The investigators will study whether high-dose amikacin (a second-line injectable), administered during the first week of RR-TB treatment, is safe in 20 patients treated for RR-TB in Rwanda. If safe, further studies will assess whether adding amikacin in the first treatment week protect against acquired bedaquiline resistance. This study is embedded in an ongoing "Master study" of the ShORRT (short oral RR-TB) treatment regimen in Rwanda, a before/after study, with a retrospective cohort (before; the previously recommended second-line injectable-containing RR-TB regimen) and a prospective cohort (after: the newly recommended ShORRT regimen).

开始日期2023-03-01

申办/合作机构

Rwanda Biomedical Centre

[+2]

IRCT20210317050735N1 / Suspended临床2期

Comparative study of the effect of Heparin alone or in combination with Amikacin and Vancomycin antibiotics in the prevention of infection caused by tunnel central catheters in patients with renal insufficiency undergoing hemodialysis

开始日期2023-02-20

申办/合作机构

Ardabil University of Medical Sciences

100 项与硫酸阿米卡星相关的临床结果

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100 项与硫酸阿米卡星相关的转化医学

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100 项与硫酸阿米卡星相关的专利（医药）

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11,923

项与硫酸阿米卡星相关的文献（医药）

2024-04-01·British journal of clinical pharmacology

A physiological approach to renal clearance: From premature neonates to adults

Article

作者: Sherwin, Catherine M. ; Hennig, Stefanie ; Holford, Nick ; Mockus, Linas ; Jacqz‐Aigrain, Evelyne ; Simon, Nicolas ; Lo, Yoke‐Lin ; Kirkpatrick, Carl ; Thomson, Alison H. ; Allegaert, Karel ; Falcão, Amilcar ; O'Hanlon, Conor J. ; Llanos‐Paez, Carolina ; Anderson, Brian

Abstract:

Aims:

We propose using glomerular filtration rate (GFR) as the physiological basis for distinguishing components of renal clearance.

Methods:

Gentamicin, amikacin and vancomycin are thought to be predominantly excreted by the kidneys. A mixed‐effects joint model of the pharmacokinetics of these drugs was developed, with a wide dispersion of weight, age and serum creatinine. A dataset created from 18 sources resulted in 27,338 drug concentrations from 9,901 patients. Body size and composition, maturation and renal function were used to describe differences in drug clearance and volume of distribution.

Results:

This study demonstrates that GFR is a predictor of two distinct components of renal elimination clearance: (1) GFR clearance associated with normal GFR and (2) non‐GFR clearance not associated with normal GFR. All three drugs had GFR clearance estimated as a drug‐specific percentage of normal GFR (gentamicin 39%, amikacin 90% and vancomycin 57%). The total clearance (sum of GFR and non‐GFR clearance), standardized to 70 kg total body mass, 176 cm, male, renal function 1, was 5.58 L/h (95% confidence interval [CI] 5.50‐5.69) (gentamicin), 7.77 L/h (95% CI 7.26‐8.19) (amikacin) and 4.70 L/h (95% CI 4.61‐4.80) (vancomycin).

Conclusions:

GFR provides a physiological basis for renal drug elimination. It has been used to distinguish two elimination components. This physiological approach has been applied to describe clearance and volume of distribution from premature neonates to elderly adults with a wide dispersion of size, body composition and renal function. Dose individualization has been implemented using target concentration intervention.

2024-04-01·Molecular biotechnology

Computational Approaches for the Structure-Based Identification of Novel Inhibitors Targeting Nucleoid-Associated Proteins in Mycobacterium Tuberculosis

Article

作者: Shukla, Pratyoosh ; Singh, Yogendra ; Gupta, Vipin ; Sunita ; Singhvi, Nirjara

Implementation of computational tools in the identification of novel drug targets for Tuberculosis (TB) has been a promising area of research. TB has been a chronic infectious disease caused by Mycobacterium tuberculosis (Mtb) localized primarily on the lungs and it has been one of the most successful pathogen in the history of mankind. Extensively arising drug resistivity in TB has made it a global challenge and need for new drugs has become utmost important.The involvement of Nucleoid-Associated Proteins (NAPs) in maintaining the structure of the genomic material and regulating various cellular processes like transcription, DNA replication, repair and recombination makes significant, has opened a new arena to find the drugs targeting Mtb. The current study aims to identify potential inhibitors of NAPs through a computational approach. In the present work we worked on the eight NAPs of Mtb, namely, Lsr2, EspR, HupB, HNS, NapA, mIHF and NapM. The structural modelling and analysis of these NAPs were carried out. Moreover, molecular interaction were checked and binding energy was identified for 2500 FDA-approved drugs that were selected for antagonist analysis to choose novel inhibitors targeting NAPs of Mtb. Drugs including Amikacin, streptomycin, kanamycin, and isoniazid along with eight FDA-approved molecules that were found to be potential novel targets for these mycobacterial NAPs and have an impact on their functions. The potentiality of several anti-tubercular drugs as therapeutic agents identified through computational modelling and simulation unlocks a new gateway for accomplishing the goal to treat TB.

2024-03-01·Respiratory investigation

Amikacin liposome inhalation suspension for Mycobacterium avium complex pulmonary disease: A subgroup analysis of Japanese patients in the randomized, phase 3, CONVERT study

Article

作者: Tsuyuguchi, Kazunari ; Morimoto, Kozo ; Yamazaki, Yoshitaka ; Nakagawa, Taku ; Yuen, Dayton W ; Hasegawa, Naoki ; Ciesielska, Monika ; Jumadilova, Zhanna ; Nonaka, Mizu ; Kitada, Seigo ; Takasaki, Jin

BACKGROUND:

CONVERT, a randomized, active-controlled, global, Phase 3 trial demonstrated that patients with treatment-refractory Mycobacterium avium complex (MAC) pulmonary disease were more likely to achieve culture conversion with amikacin liposome inhalation suspension (ALIS) plus guideline-based therapy (GBT) versus those continuing on GBT alone. This subgroup analysis reports the efficacy and safety of ALIS in Japanese patients enrolled in CONVERT.

METHODS:

Japanese patients aged ≥20 years with treatment-refractory MAC pulmonary disease from Japanese sites were included. Patients were randomized to receive once-daily 590 mg ALIS + GBT or GBT alone; patients converting by Month 6 remained in the study to complete 12-month treatment followed by a 12-month off-treatment period. Nonconverters exited the study at Month 8. The primary endpoint was the proportion of patients achieving culture conversion by Month 6.

RESULTS:

Of the 59 Japanese patients screened, 48 were randomized to receive ALIS + GBT (n = 34) or GBT alone (n = 14), and 41/48 (85.4 %) were women. The mean (standard deviation) age of patients was 64.5 (8.6) years, and 83.3 % of patients had bronchiectasis at baseline. By Month 6, sputum culture conversion was cumulatively achieved in 9/34 (26.5 %) patients receiving ALIS + GBT versus none receiving GBT alone. Treatment-emergent adverse events were reported in 94.1 % and 100.0 % of patients receiving ALIS + GBT and GBT alone, respectively. No deaths were reported.

CONCLUSIONS:

The efficacy observed in the Japanese subpopulation was largely consistent with that in the overall CONVERT study population, with more patients achieving culture conversion with ALIS + GBT versus GBT alone. Safety profiles were similar between the overall population and the Japanese subpopulation.

CLINICAL TRIAL REGISTRATION:

NCT02344004.

121

项与硫酸阿米卡星相关的新闻（医药）

2024-06-17

·信狐药迅

丽珠集团 3.3类生物类似药司美格鲁肽注射液提交上市申请|新受理（6.11-6.16）

本周药品注册受理数据，分门别类呈现，一目了然。(6.11-6.16）新药上市申请无新药临床申请药品名称企业注册分类受理号注射用莱古比星上海亲合力生物医药科技股份有限公司1CXHL2400594注射用莱古比星上海亲合力生物医药科技股份有限公司1CXHL2400593ATG-037上海德琪医药科技有限公司1CXHL2400592BGB-43395片百济神州(苏州)生物科技有限公司1CXHL2400591BGB-43395片百济神州(苏州)生物科技有限公司1CXHL2400590BGB-43395片百济神州(苏州)生物科技有限公司1CXHL2400589SY-7166片首药控股(北京)股份有限公司1CXHL2400587SY-7166片首药控股(北京)股份有限公司1CXHL2400586HP515片海创药业股份有限公司1CXHL2400585HP515片海创药业股份有限公司1CXHL2400584HP515片海创药业股份有限公司1CXHL2400583注射用美罗培南普莱巴坦齐鲁制药有限公司1CXHL2400600注射用美罗培南普莱巴坦齐鲁制药有限公司1CXHL2400599注射用美罗培南普莱巴坦齐鲁制药有限公司1CXHL2400598注射用美罗培南普莱巴坦齐鲁制药有限公司1CXHL2400597NCO-48F1片广东集宝医药技术有限公司1CXHL2400596NCO-48F1片广东集宝医药技术有限公司1CXHL2400595VV261片旺山旺水(上海)生物医药有限公司1CXHL2400604VV261片旺山旺水(上海)生物医药有限公司1CXHL2400603VV261片旺山旺水(上海)生物医药有限公司1CXHL2400602HZ029口崩片浙江和泽医药科技股份有限公司2.2CXHL2400601注射用西罗莫司(白蛋白结合型)石药集团中奇制药技术(石家庄)有限公司2.4CXHL2400588美洛昔康注射液浙江圣兆药物科技股份有限公司3CYHL2400107瑞卢戈利片北京海步医药科技有限公司3CYHL2400106硫酸亚铁缓释片吉林天衡药业有限公司3CYHL2400105氨磺必利注射液山西阳和医药技术有限公司3CYHL2400109氨磺必利注射液山西阳和医药技术有限公司3CYHL2400108氨磺必利注射液济南东方开元医药新技术有限公司3CYHL2400110瑞加诺生注射液珠海润都制药股份有限公司3CYHL2400112盐酸西替利嗪注射液中孚药业股份有限公司3CYHL2400111注射用RC88荣昌生物制药(烟台)股份有限公司1CXSL2400374注射用KJ103上海宝济药业股份有限公司1CXSL2400378注射用BB-1701百力司康生物医药(杭州)有限公司1CXSL2400377SYS6010石药集团巨石生物制药有限公司1CXSL2400376BC011抗体注射液宝船生物医药科技(上海)有限公司1CXSL2400375GQ1010注射液启德医药科技(苏州)有限公司1CXSL2400379注射用AMT-676普众发现医药科技(上海)有限公司1CXSL2400381人脐带间充质干细胞注射液杭州易文赛生物技术有限公司1CXSL2400380人GLP-1和FGF21双因子高表达脂肪干细胞注射液北京吉源生物科技有限公司1CXSL2400382SCTC21C注射液神州细胞工程有限公司1CXSL2400385SCT520FF注射液神州细胞工程有限公司1CXSL2400387BN-1001眼用注射液南京贝思奥生物科技有限公司1CXSL2400384BN-1001眼用注射液南京贝思奥生物科技有限公司1CXSL2400383SCT520FF注射液神州细胞工程有限公司1CXSL2400389SCT520FF注射液神州细胞工程有限公司1CXSL2400388GR1802注射液重庆智翔金泰生物制药股份有限公司1CXSL2400392GR1802注射液重庆智翔金泰生物制药股份有限公司1CXSL2400391SCTB41注射液神州细胞工程有限公司1CXSL2400390重组抗PD-1人源化单抗注射液复星汉霖(深圳)生物技术有限公司3.3CXSL2400386司美格鲁肽注射液惠升生物制药股份有限公司3.3CXSL2400394司美格鲁肽注射液惠升生物制药股份有限公司3.3CXSL2400393 仿制药申请药品名称企业注册分类受理号盐酸异丙嗪注射液扬州中宝药业股份有限公司3CYHS2401742地高辛注射液海南未见药业有限公司3CYHS2401746盐酸布比卡因注射液四川美大康华康药业有限公司3CYHS2401745注射用右雷佐生上海旭东海普药业有限公司3CYHS2401772琥珀酸亚铁片安徽佳和药业有限公司3CYHS2401771重酒石酸去甲肾上腺素注射液浙江博崤生物制药有限公司3CYHS2401769钠钾镁钙注射用浓溶液北京民康百草医药科技有限公司3CYHS2401763丁酸氯维地平注射用乳剂石药集团中诺药业(石家庄)有限公司3CYHS2401756丁酸氯维地平注射用乳剂石药集团中诺药业(石家庄)有限公司3CYHS2401755吸入用盐酸丙卡特罗溶液北京海步医药科技有限公司3CYHS2401753注射用青霉素钠西藏金岳医药有限公司3CYHS2401780注射用青霉素钠西藏金岳医药有限公司3CYHS2401779注射用青霉素钠西藏金岳医药有限公司3CYHS2401778吸入用盐酸丙卡特罗溶液山东如至生物医药科技有限公司3CYHS2401777硫酸阿米卡星注射液漯河市汇创医药有限公司3CYHS2401776硫酸阿米卡星注射液漯河市汇创医药有限公司3CYHS2401775硫酸镁注射液湖南恒生制药股份有限公司3CYHS2401790复方匹可硫酸钠颗粒石家庄四药有限公司3CYHS2401788洛索洛芬钠口服溶液广东万泰科创药业有限公司3CYHS2401787氨茶碱片石家庄四药有限公司3CYHS2401784注射用青霉素钠西藏金岳医药有限公司3CYHS2401782注射用青霉素钠西藏金岳医药有限公司3CYHS2401781头孢呋辛酯干混悬剂瑞阳制药股份有限公司3CYHS2401794头孢呋辛酯干混悬剂瑞阳制药股份有限公司3CYHS2401793法莫替丁注射液广州一品红制药有限公司3CYHS2401785维生素B6注射液南京思聆医药科技有限公司3CYHS2401798复方聚乙二醇电解质散(儿童型)亚宝药业集团股份有限公司3CYHS2401797盐酸昂丹司琼片成都通德药业有限公司3CYHS2401808米诺地尔搽剂贵州瑞和制药有限公司3CYHS2401807米诺地尔搽剂贵州瑞和制药有限公司3CYHS2401806复方聚乙二醇(3350)电解质散四川信拓医药技术有限公司3CYHS2401805司美格鲁肽注射液丽珠集团新北江制药股份有限公司3.3CXSS2400059司美格鲁肽注射液丽珠集团新北江制药股份有限公司3.3CXSS2400058司美格鲁肽注射液丽珠集团新北江制药股份有限公司3.3CXSS2400057低钙腹膜透析液(乳酸盐-G1.5%)海南爱科制药有限公司4CYHS2401741腹膜透析液(乳酸盐-G2.5%)海南爱科制药有限公司4CYHS2401751精氨酸布洛芬颗粒金鸿药业股份有限公司4CYHS2401750低钙腹膜透析液(乳酸盐-G2.5%)海南爱科制药有限公司4CYHS2401749沙库巴曲缬沙坦钠片湖南千金协力药业有限公司4CYHS2401748枸橼酸西地那非口腔崩解片北京星昊盈盛药业有限公司4CYHS2401747拉考沙胺注射液海南普利制药股份有限公司4CYHS2401744拉考沙胺注射液海南普利制药股份有限公司4CYHS2401743盐酸特比萘芬喷雾剂浙江高跖医药科技股份有限公司4CYHS2401770利丙双卡因乳膏浙江寰领医药科技有限公司4CYHS2401768溴莫尼定噻吗洛尔滴眼液立生医药(苏州)有限公司4CYHS2401767盐酸尼卡地平注射液浙江高跖医药科技股份有限公司4CYHS2401766二甲双胍恩格列净片(I)河南诺美药业有限公司4CYHS2401765盐酸纳呋拉啡口腔崩解片成都苑东生物制药股份有限公司4CYHS2401764苯磺酸氨氯地平片新乡市常乐制药有限责任公司4CYHS2401762西甲硅油乳剂海南斯达制药有限公司4CYHS2401761苯磺酸氨氯地平片新乡市常乐制药有限责任公司4CYHS2401760米格列奈钙片浙江易泽达医药科技有限公司4CYHS2401759米格列奈钙片浙江易泽达医药科技有限公司4CYHS2401758左卡尼汀注射液浙江普洛康裕制药有限公司4CYHS2401757腹膜透析液(乳酸盐-G1.5%)海南爱科制药有限公司4CYHS2401754精氨酸布洛芬颗粒金鸿药业股份有限公司4CYHS2401752布洛芬混悬液成都倍特得诺药业有限公司4CYHS2401774布洛芬混悬液成都倍特得诺药业有限公司4CYHS2401773西甲硅油乳剂浙江赛默制药有限公司4CYHS2401792比索洛尔氨氯地平片成都欣捷高新技术开发股份有限公司4CYHS2401791阿奇霉素干混悬剂江苏东科康德药业有限公司4CYHS2401789注射用盐酸万古霉素华北制药股份有限公司4CYHS2401786铝碳酸镁咀嚼片河南优凯制药有限公司4CYHS2401783盐酸阿莫罗芬搽剂湖南及正医药科技有限公司4CYHS2401804卡铂注射液中寰医药有限公司4CYHS2401803氨甲环酸注射液浙江兄弟药业有限公司4CYHS2401802二甲双胍维格列汀片(Ⅱ)悦康药业集团股份有限公司4CYHS2401801他克莫司胶囊江苏和晨药业有限公司4CYHS2401800他克莫司胶囊江苏和晨药业有限公司4CYHS2401799富马酸比索洛尔片四川依科制药有限公司4CYHS2401796富马酸比索洛尔片四川依科制药有限公司4CYHS2401795 进口申请药品名称企业注册分类受理号PF-06821497片Pfizer Inc.1JXHL2400133PF-06821497片Pfizer Inc.1JXHL2400132Ulixacaltamide缓释片Praxis Precision Medicines1JXHL2400136Ulixacaltamide缓释片Praxis Precision Medicines1JXHL2400135Ulixacaltamide缓释片Praxis Precision Medicines1JXHL2400134BAY 2927088片Bayer AG1JXHL2400140AZD9833片ASTRAZENECA AB1JXHL2400137Efgartigimod注射液argenx BV2.2JXSL2400113Capivasertib片AstraZeneca AB2.4JXHL2400139Capivasertib片AstraZeneca AB2.4JXHL2400138Futibatinib薄膜包衣片Taiho Oncology, Inc.5.1JXHL2400141左甲状腺素钠片Aristo Pharma GmbH5.2JYHS2400034 中药相关申请药品名称企业注册分类受理号柴黄利胆胶囊北京以岭药业有限公司1.1CXZS2400021五味消毒饮颗粒瑞阳制药股份有限公司3.1CXZS2400022参苓溃康颗粒北京盈科瑞创新医药股份有限公司1.1CXZL2400032益智安脑颗粒北京京师脑力科技有限公司1.1CXZL2400033 不包含原料药、医用氧、注射用水、氯化钠或葡萄糖注射液等申请，不包含再注册、一次性进口、技术转移、复审申请。

生物类似药临床1期申请上市

2024-06-15

·梅斯医学

「亚胺培南 + 万古霉素」都无效的肺炎，最后只用了它就搞定了？

导语社区获得性肺炎(community acquired pneumonia,CAP)是全球主要的传染病负担，是入住ICU的常见病因，指在医院外罹患的感染性肺实质炎症，包括具有明确潜伏期的病原体感染在人院后于潜伏期内发病的肺炎。临床统计约22%～42%的CAP患者需要住院治疗，其中17%～21%的住院患者为重症社区获得性肺炎（SCAP）。SCAP病的原学调查研究表明，SCAP患者最常见的病原体包括肺炎链球菌、流感嗜血杆菌和嗜肺军团杆菌等，在免疫功能低下的患者中，肺孢子菌、肺炎克雷伯菌、肺炎链球菌、流感嗜血杆菌和铜绿假单胞菌是最常见的病原体。 SCAP是一种严重且危及生命的感染，治疗方案的核心必须是有效覆盖所有可能的致病菌。许多国家制定了SCAP的诊断和治疗指南，不同的指南有不同的患者分层标准和治疗药物，但总的原则是相同的，即：覆盖解释患者病变特征和当地流行致病菌以及抗生素耐药性的最可能的所有致病菌。病例分享 55 岁男性，既往体健，因发热咳嗽 3 天入院。患者 3 天前发热，热峰 40 ℃，伴干咳、胸闷、乏力与反应迟钝、小便失禁。查体：体温 36.0 ℃，血压 105/56 mmHg，R 35 次/分，指脉氧 92%（面罩无创通气中，氧浓度 60%），嗜睡，呼之能应，两肺湿罗音，心率 90 次/分，律齐，无杂音，下肢无浮肿。实验室检查：血常规：WBC 4.05 × 109/L，N% 85.4%，淋巴细胞计数 0.38 ×109/L，CRP > 220 mg/L，PCT 14.99 ng/mL 。血生化：AST 283 U/L，ALT 91 U/L，LDH > 2150 U/L，BUN 15 mmol/L ，Cr 295 μmol/L，Na+132.7 mmol/L。血气分析：PH 7.37，PaO266 mmHg（FiO2 60%），PaCO256 mmHg；新冠核酸检测（-）、流感检测（-）。胸部 CT：提示左肺上叶与右肺中叶炎症。诊断：重症社区获得性肺炎、呼吸衰竭。后因氧合持续恶化，急诊气管插管机械通气后收入呼吸科。当时的值班医生分析，重症社区获得性肺炎（SCAP）病情危重，死亡率较高。使用碳青霉烯类药物联合万古霉素/利奈唑胺，覆盖广谱耐药革兰氏阴性菌和耐药革兰氏阳性菌（包括MRSA），大包围合情合理，因此选择亚胺培南/西司他丁联合万古霉素经验性抗菌治疗。问以上方案是否合理？不合理！答《中国成人社区获得性肺炎诊断和治疗指南（2016年版）》推荐（1）对于无基础疾病的青壮年重症CAP患者，推荐使用青霉素类/酶抑制剂复合物（阿莫西林/克拉维酸、氨苄西林/舒巴坦、阿莫西林/舒巴坦等）、第三代头孢菌素（静脉注射：头孢曲松、头孢唑肟、头孢噻肟等；口服：头孢地尼、头孢泊肟酯、头孢克肟等）、头霉素类（头孢西丁、头孢替尼、头孢美唑、头孢米诺等）、氧头孢烯类（拉氧头孢、氟氧头孢）、厄他培南等碳青霉烯类联合大环内酯类或单用呼吸喹诺酮类静脉治疗。（2）对于老年或有基础疾病的重症CAP患者，推荐青霉素类/酶抑制剂复合物、第三代头孢菌素或其酶抑制剂复合物、厄他培南等碳青霉烯类联合大环内酯类，或联合呼吸喹诺酮类。（3）对于年龄≥65岁或有基础疾病的住院CAP患者，应考虑肠杆菌科细菌感染的可能。进一步评估产ESBL（超广谱β-内酰胺酶）菌感染的风险。高危患者的经验性治疗包括头霉素类、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦或厄他培南等。（4）对于具有铜绿假单胞菌感染危险因素的CAP，推荐使用具有抗假单胞菌活性的β-内酰胺类药物(头孢他啶、头孢吡肟、哌拉西林、氨曲南、哌拉西林/他唑林)、替卡西林/克拉维酸、头孢哌酮/舒巴坦、亚胺培南/西司他丁、头孢哌酮、美罗培南等），具有抗假单胞菌活性喹诺酮类（环丙沙星、左氧氟沙星），具有抗假单胞菌活性的β-内酰胺类联合喹诺酮类或氨基糖苷类（阿米卡星、庆大霉素等），具有抗假单胞菌活性活性β-内酰胺类、氨基糖苷类、喹诺酮类三药联合。该患者为青壮年，无基础疾病，指南没有推荐使用亚胺培南/西司他丁，也没有推荐万古霉素、利奈唑胺等抗MRSA药物。该患者入院后最初接受经验性亚胺培南/西司他丁联合万古霉素抗菌治疗，但高热持续，氧合状况未见改善。第5天，肺泡灌洗液报告检出嗜肺军团菌，病原学诊断：军团菌肺炎，故患者改用阿奇霉素抗菌治疗。患者病情好转，体温逐渐恢复正常，最终顺利拔管出院。《2019 ATS/IDSA临床实践指南：成人社区获得性肺炎的诊断和治疗》推荐（1）对于无耐甲氧西林金黄色葡萄球菌（MRSA）或铜绿假单胞菌感染风险的重症CAP患者，推荐使用β-内酰胺类药物（氨苄西林/舒巴坦、头孢曲松、头孢噻肟、头孢洛林）联合口服大环内酯类药物（阿奇霉素、克拉霉素）或呼吸道喹诺酮类药物（左氧氟沙星、吉米沙星、莫西沙星）。（2）有MRSA或铜绿假单胞菌危险因素的成人CAP患者应选择抗MRSA药物（万古霉素、利奈唑胺）、抗铜绿假单胞菌药物（哌拉西林/他唑巴坦、头孢他啶、头孢吡肟、亚胺培南、氨曲南、美罗培南）。目前，我国市场上销售的碳青霉烯类抗生素有5个品种：亚胺培南、帕尼培南、比阿培南、美罗培南和厄他培南。碳青霉烯类抗菌药物抗菌谱广，抗菌活性强，对需氧菌和厌氧菌均具有抗菌作用，特别是多重耐药革兰氏阴性杆菌，如产ESBL肠杆菌科细菌有很强的抗菌活性。近年来，我国碳青霉烯类抗菌药物临床应用中出现了一些不合理的现象，耐青霉烯耐药革兰阴性杆菌感染的发病率呈快速上升趋势，尤其是碳青霉烯耐药肺炎克雷伯菌、碳青霉烯耐药鲍曼不动杆菌、碳青霉烯耐药大肠埃希菌和碳青霉烯耐药铜绿假单胞菌等因其高耐药性和快速传播能力，给临床诊疗和感染防控带来巨大挑战。《抗菌药物临床应用指导原则（2015年版）》中明确了碳青霉烯类抗菌药物临床应用的适应证具有多重耐药性但对此类药物敏感的需氧革兰氏阴性杆菌引起的严重感染，包括肺炎克雷伯菌、阴沟肠杆菌、大肠埃希菌、柠檬酸杆菌、铜绿假单胞菌、粘质沙雷菌等肠杆菌科细菌、不动杆菌属等细菌所致血流感染、下呼吸道感染等。 2021年，BMJ发表的综述《Management of pneumonia in critically ill patients》表明，与非大环内酯类药物相比，β-内酰胺类药物联合大环内酯类药物可显著改善重症CAP患者预后。与氟喹诺酮类药物相比，β-内酰胺类药物联合大环内酯类药物治疗可降低重症肺炎患者的14天和30天死亡率。联合治疗的优点是覆盖非典型病原体，并可能受益于大环内酯类药物的免疫调节作用，以减轻细菌毒力因子和过度的全身炎症反应。 CAP的经验性抗感染治疗必须以临床微生物思维为基础，避免抗菌药物的过度使用，并及时考虑特殊病原体感染或非感染性肺部疾病。综上所述，对于重症CAP患者，初始治疗为大环内酯类或氟喹诺酮类药物与β-内酰胺类药物联合治疗。β-内酰胺的选择基于假单胞菌风险因素的存在，对于MRSA的额外覆盖基于特定风险因素的存在决定。根据 IDSA/ATS 指南的建议，只有在患者存在MRSA危险因素（既往MRSA呼吸道隔离、过去90天内住院和过去90天内使用非肠道抗生素，以及当地确认的MRSA的危险因素）时，才针对MRSA进行抗菌治疗，使用药物如万古霉素或利奈唑胺。参考文献： [1]瞿介明,曹彬.中国成人社区获得性肺炎诊断和治疗指南(2016年版)[J].中华结核和呼吸杂志,2016,39(04):253-279. [2]郑旭婷,陈佰义.社区获得性肺炎经验性抗感染治疗的临床微生物思维[J].中华结核和呼吸杂志,2021,44(06):588-591. [3]中华人民共和国国家卫生健康委员会.抗菌药物临床应用指导原则（2015 年版）[J].chrome-extension://ibllepbpahcoppkjjllbabhnigcbffpi/http://www.nhc.gov.cn/ewebeditor/uploadfile/2015/09/20150928170007470.pdf. [4]中华人民共和国国家卫生健康委员会.碳青霉烯类抗菌药物临床应用专家共识[J]. http://www.nhc.gov.cn/cms-search/xxgk/getManuscriptXxgk.htm?id=95f65ca473b44746b24590e94468b8ff. [5]郑旭婷,陈佰义.社区获得性肺炎经验性抗感染治疗的临床微生物思维[J].中华结核和呼吸杂志,2021,44(06):588-591. [6]黄丹,徐中良.2016—2020年医院碳青霉烯类抗菌药物与常见碳青霉烯耐药革兰阴性杆菌调查分析[J].临床合理用药杂志,2022,15(14):40-43.DOI:10.15887/j.cnki.13-1389/r.2022.14.012. [7]C Cillóniz, Torres A , Niederman M S . Management of pneumonia in critically ill patients[J]. BMJ (Clinical research ed.), 375:e065871. 编辑：Yan

微生物疗法

2024-05-30

·PRNewswire

Insmed to Host Commercial Webinar on June 4, 2024

BRIDGEWATER, N.J., May 30, 2024 /PRNewswire/ -- Insmed Incorporated (Nasdaq:INSM), a global biopharmaceutical company on a mission to transform the lives of patients with serious and rare diseases, will host a commercial webinar on Tuesday, June 4, 2024, at 8:00 a.m. ET to discuss the market outlook for the Company's three most advanced programs, ARIKAYCE® (amikacin liposome inhalation suspension), brensocatib, and treprostinil palmitil inhalation powder (TPIP). Shareholders and other interested parties may participate in the conference call by dialing (800) 715-9871 (U.S.) and (646) 307-1963 (international) and referencing access code 7504027. The call will also be webcast live on the Company's website at . A replay of the conference call will be accessible approximately 1 hour after its completion through July 4, 2024, by dialing (800) 770-2030 (U.S.) and (609) 800-9909 (international) and referencing access code 7504027. A webcast of the call will also be archived for 90 days under the Investor Relations section of the Company's website at . About ARIKAYCE ARIKAYCE is approved in the United States as ARIKAYCE® (amikacin liposome inhalation suspension), in Europe as ARIKAYCE® Liposomal 590 mg Nebuliser Dispersion, and in Japan as ARIKAYCE® inhalation 590 mg (amikacin sulfate inhalation drug product). Current international treatment guidelines recommend the use of ARIKAYCE for appropriate patients. ARIKAYCE is a novel, inhaled, once-daily formulation of amikacin, an established antibiotic that was historically administered intravenously and associated with severe toxicity to hearing, balance, and kidney function. Insmed's proprietary PULMOVANCE® liposomal technology enables the delivery of amikacin directly to the lungs, where liposomal amikacin is taken up by lung macrophages where the infection resides, while limiting systemic exposure. ARIKAYCE is administered once daily using the Lamira® Nebulizer System manufactured by PARI Pharma GmbH (PARI). IMPORTANT SAFETY INFORMATION AND BOXED WARNING FOR ARIKAYCE IN THE U.S. Hypersensitivity Pneumonitis has been reported with the use of ARIKAYCE in the clinical trials. Hypersensitivity pneumonitis (reported as allergic alveolitis, pneumonitis, interstitial lung disease, allergic reaction to ARIKAYCE) was reported at a higher frequency in patients treated with ARIKAYCE plus background regimen (3.1%) compared to patients treated with a background regimen alone (0%). Most patients with hypersensitivity pneumonitis discontinued treatment with ARIKAYCE and received treatment with corticosteroids. If hypersensitivity pneumonitis occurs, discontinue ARIKAYCE and manage patients as medically appropriate. Hemoptysis has been reported with the use of ARIKAYCE in the clinical trials. Hemoptysis was reported at a higher frequency in patients treated with ARIKAYCE plus background regimen (17.9%) compared to patients treated with a background regimen alone (12.5%). If hemoptysis occurs, manage patients as medically appropriate. Bronchospasm has been reported with the use of ARIKAYCE in the clinical trials. Bronchospasm (reported as asthma, bronchial hyperreactivity, bronchospasm, dyspnea, dyspnea exertional, prolonged expiration, throat tightness, wheezing) was reported at a higher frequency in patients treated with ARIKAYCE plus background regimen (28.7%) compared to patients treated with a background regimen alone (10.7%). If bronchospasm occurs during the use of ARIKAYCE, treat patients as medically appropriate. Exacerbations of underlying pulmonary disease has been reported with the use of ARIKAYCE in the clinical trials. Exacerbations of underlying pulmonary disease (reported as chronic obstructive pulmonary disease (COPD), infective exacerbation of COPD, infective exacerbation of bronchiectasis) have been reported at a higher frequency in patients treated with ARIKAYCE plus background regimen (14.8%) compared to patients treated with background regimen alone (9.8%). If exacerbations of underlying pulmonary disease occur during the use of ARIKAYCE, treat patients as medically appropriate. Anaphylaxis and Hypersensitivity Reactions: Serious and potentially life-threatening hypersensitivity reactions, including anaphylaxis, have been reported in patients taking ARIKAYCE. Signs and symptoms include acute onset of skin and mucosal tissue hypersensitivity reactions (hives, itching, flushing, swollen lips/tongue/uvula), respiratory difficulty (shortness of breath, wheezing, stridor, cough), gastrointestinal symptoms (nausea, vomiting, diarrhea, crampy abdominal pain), and cardiovascular signs and symptoms of anaphylaxis (tachycardia, low blood pressure, syncope, incontinence, dizziness). Before therapy with ARIKAYCE is instituted, evaluate for previous hypersensitivity reactions to aminoglycosides. If anaphylaxis or a hypersensitivity reaction occurs, discontinue ARIKAYCE and institute appropriate supportive measures. Ototoxicity has been reported with the use of ARIKAYCE in the clinical trials. Ototoxicity (including deafness, dizziness, presyncope, tinnitus, and vertigo) were reported with a higher frequency in patients treated with ARIKAYCE plus background regimen (17%) compared to patients treated with background regimen alone (9.8%). This was primarily driven by tinnitus (7.6% in ARIKAYCE plus background regimen vs 0.9% in the background regimen alone arm) and dizziness (6.3% in ARIKAYCE plus background regimen vs 2.7% in the background regimen alone arm). Closely monitor patients with known or suspected auditory or vestibular dysfunction during treatment with ARIKAYCE. If ototoxicity occurs, manage patients as medically appropriate, including potentially discontinuing ARIKAYCE. Nephrotoxicity was observed during the clinical trials of ARIKAYCE in patients with MAC lung disease but not at a higher frequency than background regimen alone. Nephrotoxicity has been associated with the aminoglycosides. Close monitoring of patients with known or suspected renal dysfunction may be needed when prescribing ARIKAYCE. Neuromuscular Blockade: Patients with neuromuscular disorders were not enrolled in ARIKAYCE clinical trials. Patients with known or suspected neuromuscular disorders, such as myasthenia gravis, should be closely monitored since aminoglycosides may aggravate muscle weakness by blocking the release of acetylcholine at neuromuscular junctions. Embryo-Fetal Toxicity: Aminoglycosides can cause fetal harm when administered to a pregnant woman. Aminoglycosides, including ARIKAYCE, may be associated with total, irreversible, bilateral congenital deafness in pediatric patients exposed in utero. Patients who use ARIKAYCE during pregnancy, or become pregnant while taking ARIKAYCE should be apprised of the potential hazard to the fetus. Contraindications: ARIKAYCE is contraindicated in patients with known hypersensitivity to any aminoglycoside. Most Common Adverse Reactions: The most common adverse reactions in Trial 1 at an incidence ≥5% for patients using ARIKAYCE plus background regimen compared to patients treated with background regimen alone were dysphonia (47% vs 1%), cough (39% vs 17%), bronchospasm (29% vs 11%), hemoptysis (18% vs 13%), ototoxicity (17% vs 10%), upper airway irritation (17% vs 2%), musculoskeletal pain (17% vs 8%), fatigue and asthenia (16% vs 10%), exacerbation of underlying pulmonary disease (15% vs 10%), diarrhea (13% vs 5%), nausea (12% vs 4%), pneumonia (10% vs 8%), headache (10% vs 5%), pyrexia (7% vs 5%), vomiting (7% vs 4%), rash (6% vs 2%), decreased weight (6% vs 1%), change in sputum (5% vs 1%), and chest discomfort (5% vs 3%). Drug Interactions: Avoid concomitant use of ARIKAYCE with medications associated with neurotoxicity, nephrotoxicity, and ototoxicity. Some diuretics can enhance aminoglycoside toxicity by altering aminoglycoside concentrations in serum and tissue. Avoid concomitant use of ARIKAYCE with ethacrynic acid, furosemide, urea, or intravenous mannitol. Overdosage: Adverse reactions specifically associated with overdose of ARIKAYCE have not been identified. Acute toxicity should be treated with immediate withdrawal of ARIKAYCE, and baseline tests of renal function should be undertaken. Hemodialysis may be helpful in removing amikacin from the body. In all cases of suspected overdosage, physicians should contact the Regional Poison Control Center for information about effective treatment. U.S. INDICATION LIMITED POPULATION: ARIKAYCE® is indicated in adults, who have limited or no alternative treatment options, for the treatment of Mycobacterium avium complex (MAC) lung disease as part of a combination antibacterial drug regimen in patients who do not achieve negative sputum cultures after a minimum of 6 consecutive months of a multidrug background regimen therapy. As only limited clinical safety and effectiveness data for ARIKAYCE are currently available, reserve ARIKAYCE for use in adults who have limited or no alternative treatment options. This drug is indicated for use in a limited and specific population of patients. This indication is approved under accelerated approval based on achieving sputum culture conversion (defined as 3 consecutive negative monthly sputum cultures) by Month 6. Clinical benefit has not yet been established. Continued approval for this indication may be contingent upon verification and description of clinical benefit in confirmatory trials. Limitation of Use : ARIKAYCE has only been studied in patients with refractory MAC lung disease defined as patients who did not achieve negative sputum cultures after a minimum of 6 consecutive months of a multidrug background regimen therapy. The use of ARIKAYCE is not recommended for patients with non-refractory MAC lung disease. Patients are encouraged to report negative side effects of prescription drugs to the FDA. Visit , or call 1‑800‑FDA‑1088. You can also call the Company at 1-844-4-INSMED. Please see Full Prescribing Information . About Insmed Insmed Incorporated is a global biopharmaceutical company on a mission to transform the lives of patients with serious and rare diseases. Insmed's first commercial product is a first-in-disease therapy approved in the United States, Europe, and Japan to treat a chronic, debilitating lung disease. The Company is progressing a robust pipeline of investigational therapies targeting areas of serious unmet need, including neutrophil-mediated inflammatory diseases and rare pulmonary disorders. Insmed is also advancing an early-stage research engine encompassing a wide range of technologies and modalities, including artificial intelligence-driven protein engineering, gene therapy, and protein manufacturing. Insmed is headquartered in Bridgewater, New Jersey, with additional offices and research locations throughout the United States, Europe, and Japan. Visit to learn more. Contact: Investors: Bryan Dunn Executive Director, Investor Relations Insmed (646) 812-4030 [email protected] Eleanor Barisser Associate Director, Investor Relations Insmed (718) 594-5332 [email protected] Media: Mandy Fahey Executive Director, Corporate Communications Insmed (732) 718-3621 [email protected] SOURCE Insmed Incorporated

上市批准加速审批

100 项与硫酸阿米卡星相关的药物交易

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外链

KEGG	Wiki	ATC	Drug Bank
D00865	-	S01AA21 D06AX12 J01GB06	DB00479

研发状态

批准上市

10 条最早获批的记录,

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适应症	国家/地区	公司	日期
非结核分枝杆菌感染	美国	Insmed, Inc.	2018-09-28
菌血症	澳大利亚	Southern XP IP Pty Ltd	2017-02-07
复杂的尿路感染	澳大利亚	Southern XP IP Pty Ltd	2017-02-07
革兰氏阴性菌感染	澳大利亚	Southern XP IP Pty Ltd	2017-02-07
耐甲氧西林金黄色葡萄球菌感染	澳大利亚	Southern XP IP Pty Ltd	2017-02-07
新生儿败血症	澳大利亚	Southern XP IP Pty Ltd	2017-02-07
葡萄球菌感染	澳大利亚	Southern XP IP Pty Ltd	2017-02-07
细菌感染	中国	华中药业股份有限公司	1981-01-01

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适应症	最高研发状态	国家/地区	公司	日期
肺部感染	临床3期	-	Insmed, Inc.	2016-02-05
细菌性肺炎	临床3期	希腊	Bayer HealthCare AG	2014-05-20
细菌性肺炎	临床3期	西班牙	Bayer HealthCare AG	2014-05-20
革兰氏阴性菌肺炎	临床3期	美国	Bayer AG	2013-04-13
革兰氏阴性菌肺炎	临床3期	澳大利亚	Bayer AG	2013-04-13
革兰氏阴性菌肺炎	临床3期	巴西	Bayer AG	2013-04-13
革兰氏阴性菌肺炎	临床3期	加拿大	Bayer AG	2013-04-13
革兰氏阴性菌肺炎	临床3期	哥伦比亚	Bayer AG	2013-04-13
革兰氏阴性菌肺炎	临床3期	捷克	Bayer AG	2013-04-13
革兰氏阴性菌肺炎	临床3期	墨西哥	Bayer AG	2013-04-13

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研究	分期	人群特征	评价人数	分组	结果	评价	发布日期


NCT04677543 (ARISE, Corporate Publications) 人工标引	临床3期	非结核分枝杆菌感染	99	ARIKAYCE	窪積餘壓構夢製鑰醖糧(構廠膚襯壓淵製網鑰積) = 繭獵鏇觸獵獵簾淵鹽醖遞壓壓壓獵顧鏇襯窪網 (壓鏇鏇製衊糧願衊選鑰 ) 更多	积极	2023-09-05
				placebo	窪積餘壓構夢製鑰醖糧(構廠膚襯壓淵製網鑰積) = 顧齋築窪淵網範築遞鏇遞壓壓壓獵顧鏇襯窪網 (壓鏇鏇製衊糧願衊選鑰 ) 更多
NCT02344004 (CONVERT, Pubmed)	临床3期	肺部疾病	336	Amikacin Liposome Inhalation Suspension + Guideline-based therapy	鏇廠壓獵觸衊鏇憲鏇衊(繭窪齋顧齋鹹衊窪衊鹽) = Common adverse events among ALIS+GBT-treated patients (dysphonia, cough, dyspnea, hemoptysis) mainly occurred within the first 8 months of treatment 網襯餘鏇製淵襯繭築鏇 (築餘獵構廠餘構鹹製網 ) 更多	-	2021-04-19
				Guideline-based therapy alone
NCT02344004 \| NCT01315236 (Pubmed \| Eur J Drug Metab Pharmacokinet)	临床2/3期	肺部疾病	-	Amikacin Liposome Inhalation Suspension (ALIS) 590 mg	網淵鹽廠醖範築衊網獵(顧鬱遞鹹襯積齋艱廠艱) = 觸窪鏇獵繭膚遞繭鑰壓淵齋鏇繭顧襯夢觸衊憲 (鏇選鏇繭鬱憲夢選醖鏇 )	-	2021-03-01
NCT02628600 (INS-312, Pubmed)	临床3期	肺部疾病	163	Amikacin Liposome Inhalation Suspension (ALIS-naive cohort)	襯夢糧獵鹽築廠廠選遞(顧壓膚膚鏇網願積醖製) = 夢餘構壓願製網鑰窪壓淵選鹽築夢製窪顧膚夢 (鬱鏇廠鏇膚齋鬱積鹽鬱 ) 更多	-	2020-12-16
				Amikacin Liposome Inhalation Suspension (prior-ALIS cohort)	襯夢糧獵鹽築廠廠選遞(顧壓膚膚鏇網願積醖製) = 獵觸糧壓醖鹽糧鑰鏇獵淵選鹽築夢製窪顧膚夢 (鬱鏇廠鏇膚齋鬱積鹽鬱 ) 更多
ERS2020	N/A	耐药结核病	100	Amikacin therapy	憲獵觸艱廠鹽襯遞鑰憲(簾襯醖繭範願襯膚積製) = 窪鏇夢醖衊範蓋簾糧餘淵積鏇膚鏇繭淵鑰顧鑰 (鏇憲廠簾餘壓簾蓋艱衊 )	-	2020-09-07
				Bedaquiline therapy	憲獵觸艱廠鹽襯遞鑰憲(簾襯醖繭範願襯膚積製) = 艱餘願鏇製淵醖鬱製範淵積鏇膚鏇繭淵鑰顧鑰 (鏇憲廠簾餘壓簾蓋艱衊, 10% reduction)
NCT01315678 (Pubmed)	临床3期	肺囊性纤维化	302	Amikacin liposome inhalation suspension (ALIS)	糧醖製顧淵壓窪蓋鬱淵(範醖餘壓鑰繭選襯鏇醖) = the mean increases in CFQ-R score from baseline on the Respiratory Symptoms scale suggested clinically meaningful improvement in both arms at the end of treatment in cycle 1 and in the ALIS arm at the end of treatment in cycles 2 and 3; however, the changes were not statistically significant between the 2 treatment arms 壓壓鑰構願襯齋繭膚構 (鏇製憲鹹蓋壓艱願壓網 ) 更多	-	2020-03-01
				Tobramycin inhalation solution (TIS)
INHALE (Pubmed)	临床3期	革兰氏阴性菌肺炎	725	Amikacin Inhale	鹹範範餘艱選餘膚製願(顧襯膚積簾鹹憲獵醖鏇): P-Value = 0·43	不佳	2020-03-01
				Placebo
NCT02628600 (CTgov)	临床3期	非结核分枝杆菌感染 \| 肺部感染	163	Multi-drug regimen+LAI 590 mg (Prior LAI + Multidrug Regimen)	網鬱繭範築繭齋窪積鬱(鏇艱壓廠襯選鑰糧範齋) = 鏇糧構築夢積鏇壓糧簾齋獵積觸鏇築築蓋選構 (繭鹹窪餘夢窪衊壓構艱, 願壓廠鑰觸顧鹹鏇選艱 ~ 觸鏇膚鹹繭膚壓網繭齋) 更多	-	2019-11-19
				Multi-drug regimen+LAI 590 mg (Prior Multidrug Regimen Alone)	網鬱繭範築繭齋窪積鬱(鏇艱壓廠襯選鑰糧範齋) = 簾醖餘築觸鹽齋積夢範齋獵積觸鏇築築蓋選構 (繭鹹窪餘夢窪衊壓構艱, 醖積齋齋鏇艱範餘糧鹹 ~ 獵壓鑰構願夢窪製夢膚) 更多
ERS2019	N/A	肺部疾病 \| 细胞内鸟分枝杆菌感染	-	ALIS 590mg QD + GBT	夢網餘網艱衊遞鹹積構(構壓觸衊齋遞獵簾鏇鬱) = 獵窪獵獵淵範網選醖獵獵鹽觸顧鏇鏇艱鑰衊鬱 (鬱築淵鏇觸願壓願艱鑰 ) 更多	积极	2019-09-28
				GBT alone	夢網餘網艱衊遞鹹積構(構壓觸衊齋遞獵簾鏇鬱) = 蓋鏇鏇醖蓋築夢繭範鬱獵鹽觸顧鏇鏇艱鑰衊鬱 (鬱築淵鏇觸願壓願艱鑰 ) 更多
ERS2019	N/A	细胞内鸟分枝杆菌感染	-	Rifampicin (R), ethambutol (E), macrolides (M)	遞餘製鬱網範衊窪積製(構製選廠觸憲醖衊構鑰) = 願網鑰鏇遞構膚選夢鏇鏇襯壓夢窪憲艱顧獵齋 (鹹鹹壓鏇觸顧蓋製窪蓋 )	积极	2019-09-28
				Rifampicin (R), ethambutol (E), macrolides (M), amikacin (A), clofazimine (C)Rifampicin (R), ethambutol (E), macrolides (M), amikacin (A), clofazimine (C)Rifampicin (R), ethambutol (E), macrolides (M), amikacin (A), clofazimine (C)Rifampicin (R), ethambutol (E), macrolides (M), amikacin (A), clofazimine (C)	遞餘製鬱網範衊窪積製(構製選廠觸憲醖衊構鑰) = 淵鏇蓋顧顧齋壓夢製醖鏇襯壓夢窪憲艱顧獵齋 (鹹鹹壓鏇觸顧蓋製窪蓋 )