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基于T>MIC简易数学模型对二室模型的拓展适用性探讨美罗培南给药方案

陈瑶,  宋香清

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文章导航 > 药学实践与服务  > 2017 >  35(4): 341-345
陈瑶, 宋香清. 基于T>MIC简易数学模型对二室模型的拓展适用性探讨美罗培南给药方案[J]. 药学实践与服务, 2017, 35(4): 341-345. doi: 10.3969/j.issn.1006-0111.2017.04.013
引用本文: 陈瑶, 宋香清. 基于T>MIC简易数学模型对二室模型的拓展适用性探讨美罗培南给药方案[J]. 药学实践与服务, 2017, 35(4): 341-345. doi: 10.3969/j.issn.1006-0111.2017.04.013
shu
CHEN Yao, SONG Xiangqing. Meropenem regimens based on the simple mathematical model of T>MIC for two-compartment model[J]. Journal of Pharmaceutical Practice and Service, 2017, 35(4): 341-345. doi: 10.3969/j.issn.1006-0111.2017.04.013
Citation: CHEN Yao, SONG Xiangqing. Meropenem regimens based on the simple mathematical model of T>MIC for two-compartment model[J]. Journal of Pharmaceutical Practice and Service, 2017, 35(4): 341-345. doi: 10.3969/j.issn.1006-0111.2017.04.013
shu

基于T>MIC简易数学模型对二室模型的拓展适用性探讨美罗培南给药方案

doi: 10.3969/j.issn.1006-0111.2017.04.013
  • 1.

    湖南省娄底市中心医院药剂科, 湖南 娄底 417000

  • 2.

    湖南省肿瘤医院药学部, 湖南 长沙 410013

Meropenem regimens based on the simple mathematical model of T>MIC for two-compartment model

  • 1.

    Department of Pharmacy, Loudi Central Hospital, Loudi 417000, China

  • 2.

    Department of Pharmacy, Hunan Cancer Hospital, Changsha 410013, China

  • 摘要: 目的 考察T>MIC简易数学模型对二室模型的适用性，简化T>MIC计算过程，并据此探讨美罗培南给药方案。 方法 以美罗培南的推荐剂量和静脉输注时间分别为0.5 h与3 h设计6种临床常用方案（0.5 g/次 q8 h 0.5 h、0.5 g/次 q8 h 3 h、1.0 g/次 q8 h 0.5 h、1.0 g/次q8 h 3 h、2.0 g/次q8 h 0.5 h、2.0 g/次q8 h 3 h），各方案分别与美罗培南对临床常见致病菌的4种MIC敏感性折点（0.5、1、2、4 μg/ml）组合形成不同的T>MIC，每种方案的T>MIC又可根据简易模型和二室模型计算，结果形成不同方案下的T>MIC对子，T>MIC差异采用配对样本t检验，考察简易数学模型的拓展适用性。并根据简易模型计算T>MIC%，以其达到40%~100%探讨美罗培南对不同细菌感染的给药方案。 结果与结论 简易模型可替代二室模型计算T>MIC，根据该模型从理论上可方便快捷地对美罗培南给药方案进行初判和模拟优化。
    Abstract: Objective To simplify the calculation of T>MIC and evaluate meropenem regimens based on the simple mathematical model of T>MIC reported in literature for two-compartment model. Methods Six meropenem regimens were designed according to the recommended dose with the infusion duration of 0.5 h and 3 h. Four different MIC susceptibility breakpoint of meropenem against clinical microbiologic flora were used to formulate different T>MIC.Each T>MIC was calculated by both the simple and two-compartment model of T>MIC.Meropenem regimens were evaluated for different bacterial infections based on the simple model of T>MIC with 40%~100% of the T>MIC% as the target. The t-test suggested no significant difference between the pairs of T>MIC calculated by the two models. Results and Conclusion Simple model of T>MIC can replace the two-compartment model.Meropenem regimens can be optimized based on this simple model of T>MIC conveniently and quickly.
  • [1] Lee LS,Kinzig-Schippers M,Nafziger AN,et al.Comparison of 30min and 3h infusion regimens for imipenem/cilastatin and for meropenem evaluated by Monte Carlo simulation [J].Diagn Microbiol Infect Dis,2010,68(3):251-258.
    [2] Peric M,Browne FA,Jacobs MR,et al.Activity of nine oral agents against gram-positive and gram-negative bacteria encountered in community-acquired 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.
    [3] 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.
    [4] 宋香清,龙明辉,杨立平.基于T>MIC简易数学模型的哌拉西林他唑巴坦给药方案设计与优化[J].中国医院药学杂志,2016,36(11):911-916.
    [5] 宋香清,龙明辉,杨立平,等.颅脑外科手术患者术中预防使用抗菌药物追加时机与次数研究[J].中华医院感染学杂志,2016,26(18):4151-4154.
    [6] Clinical and Laboratory Standards Institute.Performance Standards for Antimicrobial Susceptibility Testing:Twenty-second Informational Supplement M100-S26[S].USA,2016:52-112.
    [7] 杨 阳,李 昕,王 林,等.基于PK/PD参数的碳青霉烯类药物给药方案设计[J].中南药学,2013,11(2):157-159.
    [8] Iakovlev SV,Beloborodov VB,Sidorenko SV,et al.Multi-centre study of comparative efficacy of meropenem and combined regimens for empirical antibacterial therapy of severe nosocomial infections:Results of clinical and pharmacoeconomic analysis[J].Antibiot Chemother,2006,51(7):15-27.
    [9] Koomanachai P,Bulik CC,Kuti JL,et al.Pharmacodynamic modeling of intravenous antibiotics against gram-negative bacteria collected in the United States[J].Clin Ther,2010,32(4):766-779.
    [10] Li C,Du X,Kuti JL,et al.Clinical pharmacodynamics of meropenem in patients with lower respiratory tract infections[J].Antimicrob Agents Chemother,2007,51(5):1725-1730.
    [11] McKinnon PS,Paladino JA,Schentag JJ.Evaluation of area under the inhibitory curve (AUIC) and time above the minimum inhibitory concentration (T>MIC) as predictors of outcome for cefepime and ceftazidime in serious bacterial infections[J].Int J Antimicrob Agents,2008,31(4):345-351.
    [12] Zhou QT,He B,Zhang C,et al.Pharmacokinetics and pharmacodynamics of meropenem in elderly Chinese with lower respiratory tract infections:Population pharmacokinetics analysis using nonlinear mixed-effects modelling and clinical pharmacodynamics study[J].Drugs Aging,2011,28(11):903-912.
    [13] Fraenkel CJ,UllbergM,Bernander S,et al.In vitro activities of three carbapenems against recent bacterial isolates from severely ill patients at Swedish hospitals[J].Scand J Infect Dis,2006,38(10):853-859.
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  • 收稿日期:  2016-09-17
  • 修回日期:  2017-01-16

基于T>MIC简易数学模型对二室模型的拓展适用性探讨美罗培南给药方案

doi: 10.3969/j.issn.1006-0111.2017.04.013
  • 1. 湖南省娄底市中心医院药剂科, 湖南 娄底 417000
  • 2. 湖南省肿瘤医院药学部, 湖南 长沙 410013
  • 收稿日期: 2016-09-17
  • 修回日期: 2017-01-16

摘要: 目的 考察T>MIC简易数学模型对二室模型的适用性，简化T>MIC计算过程，并据此探讨美罗培南给药方案。 方法 以美罗培南的推荐剂量和静脉输注时间分别为0.5 h与3 h设计6种临床常用方案（0.5 g/次 q8 h 0.5 h、0.5 g/次 q8 h 3 h、1.0 g/次 q8 h 0.5 h、1.0 g/次q8 h 3 h、2.0 g/次q8 h 0.5 h、2.0 g/次q8 h 3 h），各方案分别与美罗培南对临床常见致病菌的4种MIC敏感性折点（0.5、1、2、4 μg/ml）组合形成不同的T>MIC，每种方案的T>MIC又可根据简易模型和二室模型计算，结果形成不同方案下的T>MIC对子，T>MIC差异采用配对样本t检验，考察简易数学模型的拓展适用性。并根据简易模型计算T>MIC%，以其达到40%~100%探讨美罗培南对不同细菌感染的给药方案。 结果与结论 简易模型可替代二室模型计算T>MIC，根据该模型从理论上可方便快捷地对美罗培南给药方案进行初判和模拟优化。

English Abstract

陈瑶, 宋香清. 基于T>MIC简易数学模型对二室模型的拓展适用性探讨美罗培南给药方案[J]. 药学实践与服务, 2017, 35(4): 341-345. doi: 10.3969/j.issn.1006-0111.2017.04.013
引用本文: 陈瑶, 宋香清. 基于T>MIC简易数学模型对二室模型的拓展适用性探讨美罗培南给药方案[J]. 药学实践与服务, 2017, 35(4): 341-345. doi: 10.3969/j.issn.1006-0111.2017.04.013
shu
CHEN Yao, SONG Xiangqing. Meropenem regimens based on the simple mathematical model of T>MIC for two-compartment model[J]. Journal of Pharmaceutical Practice and Service, 2017, 35(4): 341-345. doi: 10.3969/j.issn.1006-0111.2017.04.013
Citation: CHEN Yao, SONG Xiangqing. Meropenem regimens based on the simple mathematical model of T>MIC for two-compartment model[J]. Journal of Pharmaceutical Practice and Service, 2017, 35(4): 341-345. doi: 10.3969/j.issn.1006-0111.2017.04.013
shu

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