氟喹诺酮类药物治疗天津地区常见致病菌感染的疗效评价
发布时间：2018-11-10 15:43
【摘要】：目的根据药动学/药效学(PK/PD)理论评价氟喹诺酮类药物(FQNs)抗感染治疗的给药方案。方法应用蒙特卡洛模拟(monte carlo simulation,MCS)方法对FQNs治疗天津地区常见致病菌引起的感染进行模拟,依据达标概率(probability of target attainment,PTA)评价疗效并推荐给药方案。结果 FQNs 7种给药方案治疗由大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌、金黄色葡萄球菌、粪肠球菌及屎肠球菌引起的感染的PTA均为0(MIC90)。参考细菌MIC50值推荐给药方案:对于革兰阴性菌,仅肺炎克雷伯菌感染推荐左氧氟沙星200mg qd;对于革兰阳性菌,金黄色葡萄球菌感染推荐左氧氟沙星200mg qd和莫西沙星400mg qd,左氧氟沙星750mg qd和莫西沙星400mg qd为粪肠球菌感染时的推荐给药方案,屎肠球菌感染则不推荐给予FQNs。结论运用PK/PD模型的蒙特卡洛模拟可协助临床综合考虑药物的体外活性与感染人群的药代动力学特性,FQNs常用给药方案治疗天津地区常见致病菌感染的疗效不佳,经验性治疗上述菌种引起的感染时不推荐首选FQNs,治疗感染性疾病尚需根据适应症来选择抗菌给药方案。
[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.
【作者单位】： 天津医科大学一中心临床学院;天津市第一中心医院;天津市卫生计生委;
【分类号】：R969
，
本文编号：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.
【作者单位】： 天津医科大学一中心临床学院;天津市第一中心医院;天津市卫生计生委;
【分类号】：R969
，
本文编号：2322863
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