注射用哌拉西林钠/他唑巴坦钠的PK/PD对临床用药方案优化的意义  

Significance of PK/PD characteristics of piperacillin sodium/tazobactam sodium for optimization of clinical medication regimen

作　　者：白艳[1] 夏蕾[2] 柴栋[3] 王睿[4] 王瑾[4] 

机构地区：[1]解放军总医院药理药学研究室,北京100853 [2]解放军总医院药学部,北京100853 [3]解放军总医院临床药学中心,北京100853 [4]解放军总医院药物临床研究中心,北京100853

出　　处：《中国药物应用与监测》2017年第5期305-309,共5页Chinese Journal of Drug Application and Monitoring

基　　金：十二五国家重大科技专项基金资助项目(2012ZX09303004-002);解放军总医院临床科研扶持基金项目(2016-CXYY-2013)

摘　　要：目的:综述临床治疗重症感染常用β-内酰胺酶抑制剂复合制剂注射用哌拉西林钠/他唑巴坦钠的PK/PD特点对临床用药方案优化的意义。方法:通过查阅国内外依据注射用哌拉西林钠/他唑巴坦钠药动学和药效学特征进行最佳临床给药方案研究的文献,对注射用哌拉西林钠/他唑巴坦钠传统给药方案存在问题、PK/PD研究现状、国际国内指南推荐给药方案、重症感染患者用药方案优化等研究热点进行总结。结果:最大限度地增加f T>MIC是注射用哌拉西林钠/他唑巴坦钠获得有效临床效果的关键,部分研究表明延长输注时间或持续滴注可增加%f T>MIC的达标率,并降低患者死亡率、减少住院天数、提高细菌清除率。结论:基于PK/PD理论,延长注射用哌拉西林钠/他唑巴坦钠输注时间或持续滴注的疗效优于传统快速滴注给药方案,而准确的定量比较不同给药方案之间的优劣将成为未来研究的主要方向。Objective：To review the significance of PK/PD characteristics of piperacillin sodium/tazobactam sodium（β-lactamase inhibitor compound preparation） for optimization of clinical medication regimen.Methods：The domestic and foreign literature on the optimal clinical dosing regimen based on the pharmacokinetic and pharmacodynamic characteristics of piperacillin sodium/tazobactam sodium for injection were collected.And then the hot issues of the problem of conventional treatment scheme,the status of PK/PD research,the recommendation of the international and domestic guidelines for the drug regimen,and the optimization of the drug regimen for patients with severe infection were summarized.Results：Increasing maximally fT 〉MIC was the keypoint to achieve valid therapeutic effect of piperacillin sodium/tazobactam sodium for injection.Some studies showed that prolonged infusion or continuous drip could increase the probability of target attainment of %fT 〉MIC,reduce patients＇ death rate,shorten days of hospitalization and improve bacterial clearance rate.Conclusion：Prolonged infusion time or sustained infusion was better way to improve the efficiency of piperacillin sodium/tazobactam sodium for injection than the conventional administration according to the PK/PD theoretical guidance.Compared studies on different drug schemes of piperacillin sodium/tazobactam sodium for injection based on accurate quantification will be the main research direction in the future.

关 键 词：哌拉西林钠/他唑巴坦钠 药代动力学 药效动力学 临床用药 方案优化 

分 类 号：R969[医药卫生—药理学]