摘要
目的利用蒙特卡洛模拟法优化舒巴坦在重症连续性静脉-静脉血液滤过患者中的给药方案。方法收集舒巴坦在重症连续性静脉-静脉血液滤过患者的药动学/药效学(PK/PD)参数与鲍曼不动杆菌最低抑菌浓度(MIC),进行5000次蒙特卡洛模拟,评估给药方案的合理性。鲍曼不动杆菌的PK/PD靶值为40%f T>MIC和60%f T>MIC。结果对于鲍曼不动杆菌引起的重症连续性静脉-静脉血液滤过患者,当MIC=4 mg·L^(-1)时,推荐给药方案分别为0.5 h传统静脉输注1 g,q8h和1 g,q6h。在2种PK/PD靶值下推荐的经验性给药方案分别是24 h连续性静脉输注9 g,q24h和12 g,q24h。结论针对敏感率较低的鲍曼不动杆菌菌株,推荐采用3 h延长静脉输注或24 h连续性静脉输注的给药方案。
AIM To optimize sulbactam regimens for intensive care unit(ICU)continuous veno-venous hemofiltration(CVVH)patients using the Monte Carlo simulation method.METHODS Pharmacokinetic/pharmacodynamic(PK/PD)parameters of sulbactam in ICU CVVH patients and the minimum inhibitory concentration(MIC)of Acinetobacter baumannii(AB)were collected.Monte Carlo simulations(n=5000)were conducted to assess the rationality of the dosing regimen.The PK/PD target values for AB were 40%fT>MIC and 60%fT>MIC.RESULTS For ICU patients with CVVH caused by AB,when the MIC was 4 mg·L^(-1),the recommended dosing regimens were traditional intravenous infusions of 1 g,q8h and 1 g,q6h(with each dose infused over 0.5 h).The empiric dosing regimens recommended under 2 PK/PD target values were 24-hour continuous intravenous infusion of 9 g,q24h and 12 g,q24h.CONCLUSION It is recommended to use either a 3-hour extended intravenous infusion or a 24-hour continuous intravenous infusion regimen for the treatment of AB strains with lower susceptibility.
作者
李颖
余佩
薛飞
陈敏纯
王登
董亚琳
LI Ying;YU Pei;XUE Fei;CHEN Minchun;WANG Deng;DONG Yalin(Department of Pharmacy,Xi’an NO.3 Hospital,The Affiliated Hospital of Northwest University,Xi’an 710021,China;Xi’an International University,Xi’an 710077,China;Department of Pharmacy,The first affiliated hospital of Xi’an Jiaotong University,Xi’an 710061,China)
出处
《中国临床药学杂志》
CAS
2024年第1期30-35,共6页
Chinese Journal of Clinical Pharmacy
基金
陕西省自然科学基础研究计划青年基金(编号2019JQ-475)
西安市第三医院国科金青年培训项目(编号Y2023qn0008)
关键词
药动学/药效学
舒巴坦
蒙特卡洛模拟
重症
血液滤过
鲍曼不动杆菌
pharmacokinetic/pharmacodynamic
sulbactam
Monte Carlo method
continuous venovenous hemofiltration
Acinetobacter baumannii
作者简介
第一作者:李颖,主管药师。研究方向:抗感染药物个体化给药。E-mail:775638582@qq.com;通信作者:董亚琳,主任药师。研究方向:个体化给药。E-mail:dongyalin@mail.xjtu.edu.cn
