Clinical observation of piperacillin/tazobactam's optimized regimen formulated by T >MIC% for 59 patients with P.aeruginosa infection
-
摘要: 目的 观察T> MIC%指导优化的哌拉西林/他唑巴坦抗铜绿假单胞菌感染方案的疗效。 方法 选择2015年1-4月病原学确诊为铜绿假单胞菌感染且对哌拉西林/他唑巴坦敏感的住院患者59例，治疗前随机分为对照组和试验组。对照组采用哌拉西林/他唑巴坦4.5 g，q6 h的方案；试验组采用哌拉西林/他唑巴坦4.5 g，q12 h的方案。2组均联合阿米卡星15 mg/（kg·d），qd的方案共同治疗。其他治疗方法相同。 结果 2组患者临床治疗有效率和总住院时间相当、细菌清除率和不良反应发生率相似、治疗前后CRP和APACHE Ⅱ评分无差异。 结论 依据T> MIC%指导优化的哌拉西林/他唑巴坦抗铜绿假单胞菌感染方案安全、有效、可行。
-
关键词:
- 哌拉西林/他唑巴坦 /
- 铜绿假单胞菌 /
- 药动学/药效学理论 /
- 血药浓度大于最低抑菌浓度的持续时间
Abstract: Objective To observe the treatment efficacy of piperacillin/tazobactam regime for P.aeruginosa infection formulated by the method of the ratio of T above MIC (T >MIC%). Methods 59 hospitalized patients with P.aeruginosa infection were diagnosed by etiological diagnosis which was sensitive to piperacillin/tazobactam from Jan. to April.2015. Before treatment, all patients were randomly divided into the control group and the test group. Patients in the control group were treated with 4.5 g piperacillin/tazobactam once and repeated every six hours. Patients in test group were treated with 4.5 g piperacillin/tazobactam once and repeated every twelve hours. The two groups were injected by 15 mg/kg amikacin once a day based on the above program. The other treatments were kept to be same. Results Between the two groups, the clinical efficiency rate and total hospital stay were equivalent, bacterial clearance rate and incidence of adverse reactions were similar, there were no difference between CRP and APACHE Ⅱ score before and after treatment. Conclusion The regime of piperacillin/tazobactam for P.aeruginosa infection formulated by the method of the ratio of T above MIC (T >MIC%)was safe, effective and feasible. -
[1] Dagan R,Klugman KP,Craig WA,et al.Evidence to support the rationale that bacterial eradication in respiratory tract infection is an important aim of antimicrobial therapy[J].J Antimicrob Chemother,2001,47(2):129-140. [2] Cazzola M,Di Perma F,Boveri B,et al.Interrelationship between the pharmacokinetics and pharmacodynamics of cefaclor advanced formulation in patients with acute exacetbation of chronic bronchitis[J].J Chemother,2000,12(3):216-222. [3] Shea KM,Cheatham SC,Smith DW,et al. Comparative pharmacodynamics of intermittent and prolonged infusions of piperacillin/tazobactam using Monte Carlo simulations and steady-state pharmacokinetic data from hospitalized patients[J].Ann Pharmacother,2009,43(11):1747-1754. [4] Peric M,Browne FA,Jacobs MR,et a1.Activity of nine oral agents against gram-positive and gram-negative bacteria encountered in community-acquimd infections:use of pharmacokinetic/pharmacodynamic breakpoints in the comparative assessment of beta-lactam and macrolide antimicrobial agents[J].Clin Ther,2003,25(1):169-177. [5] 中华医学会呼吸病学分会感染学组.铜绿假单胞菌下呼吸道感染诊治专家共识[J].中华结核和呼吸杂志,2014,37(1):9. [6] 姚欣凯,李苌清,吴亚陵,等.应用PK/PD模型和蒙特卡洛模拟优化ICU中铜绿假单胞菌感染的初始给药方案[J].中国药房,2015,26(8):1060-1062. [7] 李 耘,吕 媛,薛 峰,等.卫生部全国细菌耐药监测网(Mohnarin)2011-2012年革兰阴性菌耐药监测报告[J].中国临床药理学杂志,2014,30(3):260-277. [8] 施晓群,孙景勇,倪语星,等.2011年中国CHINET铜绿假单胞菌耐药性监测[J].中国感染与化疗杂志,2013,13(3):218-221. [9] 李小芳,宋香清.哌拉西林他唑巴坦抗铜绿假单胞菌感染的T >MIC%的推导及在方案评价与优化中的作用[J].中国药师,2015,18(7):1086-1091. [10] 冒国光,章 辉,张道友,等.注射用哌拉西林/舒巴坦治疗呼吸和泌尿系统感染多中心临床研究[J].药学与临床研究,2011,19(1):13-17. [11] 何 聪,申丽旻,杜全胜,等.根据PK/PD理论指导哌拉西林他唑巴坦治疗革兰阴性杆菌感染的临床观察[J].临床合理用药杂志,2014,7(10A):41-42. [12] 王 丽,马 杰,李顺清,等.重症监护病房革兰阴性杆菌耐药性监测[J].中华医院感染学杂志,2007,17(9):1145-1146. [13] 庞晓军,杜正隆,梁 耿,等.临床药师参与危重病患者的药学服务[J].中国医院药学杂志,2010,30(17):1495-1497. [14] 张 玲,艾 青.感染与C-反应蛋白的关系[J].吉林医学,2000,21(6):333-334. -
点击查看大图
计量
- 文章访问数: 2831
- HTML全文浏览量: 261
- PDF下载量: 970
- 被引次数: 0
下载:
