应用蒙特卡洛模拟筛选头孢他啶治疗肺炎克雷伯菌感染的方案  

Application of MCS to screening ceftazidine for the treatment of pneumonia klebsiella bacteria infection

作　　者：胡秀萍[1] 陈新贵[1] 王小庆[1] 

机构地区：[1]滁州市第一人民医院药剂科,安徽滁州239000

出　　处：《安徽医药》2017年第3期550-553,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的依据头孢他啶药代药动学理论,筛选头孢他啶抗肺炎克雷伯杆菌(KP)感染的给药方案,为临床合理用药提供参考。方法设定游离药物浓度超过最小抑菌浓度(MIC)的时间比例超过40%和70%可分别获得最大抑菌和杀菌速率,应用蒙特卡洛模拟对各种给药方案进行50 000次模拟,比较目标获得概率(PTA)、累积反应分数(CFR)和各参数敏感性。结果MIC大于3.0、6.0、9.0 mg·L^(-1)时,PTA和CFR均大于90%的给药方案分别有8、7、6种;CFR均大于90%的给药方案有8种;MIC和半衰期是模拟预测中的主要影响因素。结论 MIC>3.0 mg·L^(-1),剔除1.0 g每24小时给药方案,MIC>6.0 mg·L^(-1)时,剔除1.0 g和2.0 g每24小时两种给药方案,MIC>9.0 mg·L^(-1)时,剔除1.0 g、2.0 g和3.0 g每24小时三种给药方案。Objective To optimize the dosage regimen of ceftazidine resistance to infection of KP,based on the theory of ceftazidine PK/PD,and to provide reference for rational usage of the drug. Methods Assuming that maximum bacteriostatic and bactericidal rates were obtained when the time scales of free drug concentration were higher than MIC by 40% and 70%,respectively,50 000 times of simulation with MCS were carried out on the various dosage regimen,PTA,CFR and each parameter sensitivity were compared. Results When minimum inhibitory concentration(MIC) was greater than 3. 0,6. 0 and 9. 0 mg · L^(-1),there were eight,seven,six kinds of dosage regimen in which PTA and CFR were both greater than 90%. In 8 kinds of dosage regimen bacteriostatic CFR was greater than90%. MIC and half-life are main influence factors in the simulation. Conclusions When MIC is greater than 3. 0,6. 0 and 9. 0 mg·L^(-1),1. 0 g q24 h,1. 0 and 2. 0 g q24 h,1. 0 ~ 3. 0 g q24 h dosage regimen are left out.

关 键 词：头孢他啶 计算机模拟 药代动力学 

分 类 号：R515[医药卫生—内科学]