亚胺培南治疗严重烧伤感染患者的疗效评价  

Evaluation of imipenem dosing regimens for patients with severe burn infection

作　　者：李娜[1] 朱立勤[2] 刘薇 葛婷悦 许高奇 廖莎莎[1] 

机构地区：[1]天津医科大学一中心临床学院,天津300192 [2]天津市第一中心医院,天津300192 [3]天津市卫生计生委,天津300070

出　　处：《中国新药杂志》2017年第7期787-790,共4页Chinese Journal of New Drugs

摘　　要：目的:评价亚胺培南不同给药方案治疗严重烧伤感染的疗效并推荐给药方案。方法:应用蒙特卡洛模拟(Monte Carlo simulation,MCS)方法对亚胺培南治疗严重烧伤感染的各方案进行模拟,设置%T>4MIC大于40%为目标靶值,获得累积反应分数(cumulative fraction of response,CFR),评价疗效并推荐给药方案。结果:对于大肠埃希菌和肺炎克雷伯菌感染,亚胺培南500 mg q6h,1 000 mg q8h和1 000 mg q6h分别静脉注射(iv)3 h给药方案的CFR>90%。考虑到临床实际情况和患者的依从性,推荐给药方案为500 mg,q6h,iv 3 h;对于铜绿假单胞菌和鲍曼不动杆菌感染,所有给药方案的CFR<90%,推荐联合用药。结论:亚胺培南治疗严重烧伤感染,当日剂量相同时,增加给药频次和输注时间可提高临床疗效。Objective： To evaluate and optimize different dosage regimens of imipenem for severe burn infections. Methods： Cumulative fraction of response（ CFR） obtained by Monte Carlo simulation（ MCS） were used to evaluate the effect of imipenem dosage regimens. Setting % T 〉4MIC above 40% and obtaining CFR of different dosage regimens,the best dosage regimen would be recommended according to CFR. Results： The CFRs of imipenem 500 mg q6 h,1 000 mg q8 h and 1 000 mg q6 h,iv for 3 h,were more than 90% for severe burn patients infected with Escherichia coli and Klebsiella pneumonia. Taking into account the clinical practice and patient compliance,the optimal dosage regimen of imipenem was 500 mg q6 h iv for 3 h. Since CFR of imipenem dosing regimens were less than 90% for severe burn patients infected with Pseudomonas aeruginosa and Acinetobacter baumannii,combined medication was thereby recommended. Conclusion： When imipenem is prescribed for severe burn infections and the daily dosage is fixed,increasing the dosing frequency and prolonging the infusion time can improve the clinical outcome.

关 键 词：亚胺培南 烧伤感染 药动学/药效学 革兰阴性菌 

分 类 号：R978.1[医药卫生—药品]