美罗培南基于TDM个体化治疗重症感染患者的研究应用  

Research and application of personalized treatment of severe infection patients with Meropenem based on TDM

作　　者：王文娟 路佩源 杨晓彤 陈莉 赵银枝 袁媛[2] WANG Wenjuan;LU Peiyuan;YANG Xiaotong;CHEN Li;ZHAO Yinzhi;YUAN Yuan(Gansu University of Chinese Medicine,First Clinical Medical College,Gansu Provincial People's Hospital,Lanzhou 730000,Gansu,China;Department of Critical Care Medicine,Gansu Provincial People's Hospital,Lanzhou 730000,Gansu,China)

机构地区：[1]甘肃中医药大学第一临床医学院,甘肃兰州730000 [2]甘肃中医药大学甘肃省人民医院重症医学科,甘肃兰州730000

出　　处：《中国临床药理学与治疗学》2024年第12期1329-1336,共8页Chinese Journal of Clinical Pharmacology and Therapeutics

基　　金：甘肃省科技重大专项-社会发展类项目(22ZD1FA001);甘肃省卫生健康行业计划(GSWSKY2020-37);甘肃省中医药管理局项目(GZKZ-2022-6)。

摘　　要：重症感染是患者安全和生存率的重要威胁。美罗培南作为院内感染的主要治疗药物,由于耐药性的出现,治疗效果受到限制,尤其是在长期使用抗生素后常见耐药性。因此,优化美罗培南等抗生素的疗效并避免微生物耐药性成为急需解决的问题。治疗药物监测(TDM)作为实现个体化给药的重要工具,在重症患者和肾功能不全患者中越来越被认为是优化抗生素浓度、避免治疗失败和毒性的重要策略。本文通过综述美罗培南的应用现状、药代动力学和TDM指导,以为危重症患者和肾功能不全患者的治疗提供参考,为优化抗生素治疗提供依据。Severe infection is a significant threat to patient safety and survival.As the main treatment for hospital acquired infections,meropenem is limited in its effectiveness due to the emergence of drug resistance,especially after long-term use of antibiotics.Therefore,optimizing the efficacy of antibiotics such as meropenem and avoiding microbial resistance has become an urgent issue to be addressed.Therapeutic drug monitoring(TDM),as an important tool for achieving personalized drug administration,is increasingly recognized as an important strategy for optimizing antibiotic concentration,avoiding treatment failure and toxicity in critically ill patients and patients with renal insufficiency.By reviewing the current application status,pharmacokinetics,and TDM guidance of meropenem,clinical references are provided for the treatment of critically ill patients and patients with renal insufficiency,and guidance and support are provided for optimizing antibiotic treatment.

关 键 词：美罗培南 TDM 重症感染 肾功能异常 

分 类 号：R969[医药卫生—药理学]