常用抗感染药物是否在Pharm GKB数据库中有相关代谢基因的证据学习 2

根据抗菌药物指导原则，脑外科手术（清洁，无植入物）可能的污染菌为金黄色葡萄球菌，凝固酶阴性葡萄球菌，推荐预防用第一、第二代头孢菌素如头孢唑啉和头孢呋辛，；关节置换成形术、骨内固定术、脊柱手术常见污染菌为金黄色葡萄球菌、凝固酶阴性葡萄球菌和链球菌属，有循证医学证据的预防用抗菌药物为头孢唑啉或头孢呋辛。对头孢菌素过敏史者可选择克林霉素，MRSA高危患者可选择万古霉素。
头孢唑啉（Cefazolin）： 目前Pharm GKB数据库中还未收录与其相关基因。
头孢呋辛（Cefuroxime）：目前Pharm GKB数据库中还未收录与其相关基因。
克林霉素（Clindamycin）：目前Pharm GKB数据库中报道与克林霉素相关基因为HLA-B，但相关研究较少，属Level 3。
Patients with one or two copies of the HLA-B*51:01:01 allele may have an increased risk of cutaneous adverse drug reactions when treated with clindamycin as compared to patients with no HLA-B*51:01:01 alleles or negative for the HLA-B*51:01:01 test. （患有HLA-B*51:01:01等位基因的一个或两个拷贝的患者可能具有增加皮肤药物不良反应风险）
Patients with one or two copies of the HLA-B*15:27:01 allele may have an increased risk of cutaneous adverse drug reactions when treated with clindamycin as compared to patients with no HLA-B*15:27:01 alleles or negative for the HLA-B*15:27:01 test.（患有HLA-B*15:27:01等位基因的一个或两个拷贝的患者可能具有增加皮肤药物不良反应风险）
万古霉素（Vancomycin）：目前Pharm GKB数据库中报道rs2789047突变影响万古霉素代谢，但相关研究较少，属Level 3。
Chromosome 6q22.31 locus was associated with increased serum creatinine levels while on vancomycin therapy (most significant variant rs2789047）
Patients with the AA genotype may have a greater likelihood of experiencing an increase in serum creatine kinase when exposed to vancomycin as compared with patients with the AC and CC genotypes. Other clinical and genetic factors may also affect serum creatine kinase in patients taking vancomycin.
Patients with the AG genotype may have a greater likelihood of experiencing an increase in serum creatine kinase when exposed to vancomycin as compared with patients with the CC genotype and a lower likelihood as compared to patients with the AA genotype. Other clinical and genetic factors may also affect serum creatine kinase in patients taking vancomycin.
Patients with the CC genotype may have a lower likelihood of experiencing an increase in serum creatine kinase when exposed to vancomycin as compared with patients with the AA genotypes. Other clinical and genetic factors may also affect serum creatine kinase in patients taking vancomycin.
注：肌酐（creatinine）衡量肾功能

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