氟喹諾酮類藥物治療天津地區(qū)常見致病菌感染的療效評價
發(fā)布時間：2018-11-10 15:43
【摘要】：目的根據(jù)藥動學/藥效學(PK/PD)理論評價氟喹諾酮類藥物(FQNs)抗感染治療的給藥方案。方法應用蒙特卡洛模擬(monte carlo simulation,MCS)方法對FQNs治療天津地區(qū)常見致病菌引起的感染進行模擬,依據(jù)達標概率(probability of target attainment,PTA)評價療效并推薦給藥方案。結(jié)果 FQNs 7種給藥方案治療由大腸埃希菌、肺炎克雷伯菌、鮑曼不動桿菌、銅綠假單胞菌、金黃色葡萄球菌、糞腸球菌及屎腸球菌引起的感染的PTA均為0(MIC90)。參考細菌MIC50值推薦給藥方案:對于革蘭陰性菌,僅肺炎克雷伯菌感染推薦左氧氟沙星200mg qd;對于革蘭陽性菌,金黃色葡萄球菌感染推薦左氧氟沙星200mg qd和莫西沙星400mg qd,左氧氟沙星750mg qd和莫西沙星400mg qd為糞腸球菌感染時的推薦給藥方案,屎腸球菌感染則不推薦給予FQNs。結(jié)論運用PK/PD模型的蒙特卡洛模擬可協(xié)助臨床綜合考慮藥物的體外活性與感染人群的藥代動力學特性,FQNs常用給藥方案治療天津地區(qū)常見致病菌感染的療效不佳,經(jīng)驗性治療上述菌種引起的感染時不推薦首選FQNs,治療感染性疾病尚需根據(jù)適應癥來選擇抗菌給藥方案。
[Abstract]:Objective to evaluate the antiinfective regimen of fluoroquinolones (FQNs) based on pharmacokinetics / pharmacodynamics (PK/PD) theory. Methods Monte Carlo simulated (monte carlo simulation,MCS was used to simulate FQNs in the treatment of infections caused by common pathogenic bacteria in Tianjin. According to the probability of meeting the standard (probability of target attainment,PTA, the curative effect was evaluated and the regimen was recommended. Results the PTA of seven FQNs regimens in the treatment of infections caused by Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Staphylococcus aureus, Enterococcus faecalis and Enterococcus faecium were 0 (MIC90). Reference bacterial MIC50 recommended regimen: for Gram-negative bacteria, levofloxacin 200mg qd; recommended for Klebsiella pneumoniae infection only For Gram-positive bacteria, levofloxacin 200mg qd and moxifloxacin 400mg qd, levofloxacin 750mg qd and moxifloxacin 400mg qd were recommended for enterococcus faecalis infection. Enterococcus faecium infection is not recommended for FQNs. Conclusion Monte Carlo simulation based on PK/PD model can help clinical patients to consider the drug activity in vitro and pharmacokinetic characteristics of infected population. The commonly used FQNs regimen for the treatment of common pathogenic bacteria infection in Tianjin is not effective. The first choice of FQNs, in the treatment of infectious diseases should be selected according to the indications.
【作者單位】： 天津醫(yī)科大學一中心臨床學院;天津市第一中心醫(yī)院;天津市衛(wèi)生計生委;
【分類號】：R969
，
本文編號：2322863
[Abstract]:Objective to evaluate the antiinfective regimen of fluoroquinolones (FQNs) based on pharmacokinetics / pharmacodynamics (PK/PD) theory. Methods Monte Carlo simulated (monte carlo simulation,MCS was used to simulate FQNs in the treatment of infections caused by common pathogenic bacteria in Tianjin. According to the probability of meeting the standard (probability of target attainment,PTA, the curative effect was evaluated and the regimen was recommended. Results the PTA of seven FQNs regimens in the treatment of infections caused by Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Staphylococcus aureus, Enterococcus faecalis and Enterococcus faecium were 0 (MIC90). Reference bacterial MIC50 recommended regimen: for Gram-negative bacteria, levofloxacin 200mg qd; recommended for Klebsiella pneumoniae infection only For Gram-positive bacteria, levofloxacin 200mg qd and moxifloxacin 400mg qd, levofloxacin 750mg qd and moxifloxacin 400mg qd were recommended for enterococcus faecalis infection. Enterococcus faecium infection is not recommended for FQNs. Conclusion Monte Carlo simulation based on PK/PD model can help clinical patients to consider the drug activity in vitro and pharmacokinetic characteristics of infected population. The commonly used FQNs regimen for the treatment of common pathogenic bacteria infection in Tianjin is not effective. The first choice of FQNs, in the treatment of infectious diseases should be selected according to the indications.
【作者單位】： 天津醫(yī)科大學一中心臨床學院;天津市第一中心醫(yī)院;天津市衛(wèi)生計生委;
【分類號】：R969
，
本文編號：2322863
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