PDF(Pubmed)
Abstract：
This study aimed to explore the changes of pharmacokinetic parameters after meropenem in patients with abdominal septic shock after gastrointestinal perforation, and to simulate the probability of different dosing regimens achieving different pharmacodynamic goals. The study included 12 patients, and utilized high performance liquid chromatography-tandem mass spectrometry to monitor the plasma concentration of meropenem. The probability of target attainment (PTA) for different minimum inhibitory concentration (MIC) values and %fT > 4MIC was compared among simulated dosing regimens. The results showed that in 96 blood samples from 12 patients, the clearance (CL) of meropenem in the normal and abnormal creatinine clearance subgroups were 7.7 ± 1.8 and 4.4 ± 1.1 L/h, respectively, and the apparent volume of distribution (Vd) was 22.6 ± 5.1 and 17.2 ± 5.8 L, respectively. 2. Regardless of the subgroup, 0.5 g/q6h infusion over 6 h regimen achieved a PTA > 90% when MIC ≤ 0.5 mg/L. 1.0 g/q6h infusion regimen compared with other regimen, in most cases, the probability of making PTA > 90% is higher. For patients at low MIC, 0.5 g/q6h infusion over 6 h may be preferable. For patients at high MIC, a dose regimen of 1.0 g/q6 h infusion over 6 h may be preferable. Further research is needed to confirm this exploratory result.
摘要：
本研究旨在探讨胃肠道穿孔后感染性休克患者应用美罗培南后的药代动力学参数变化。并模拟不同给药方案实现不同药效学目标的概率。该研究包括12名患者，并利用高效液相色谱-串联质谱法监测血浆中美罗培南的浓度。在模拟给药方案中比较了不同最小抑制浓度(MIC)值和%fT>4MIC的目标达到(PTA)的概率。结果显示，在12名患者的96份血液样本中，肌酐清除率正常和异常亚组的美罗培南清除率（CL）分别为7.7±1.8和4.4±1.1L/h，分别,表观分布容积(Vd)分别为22.6±5.1和17.2±5.8L,分别。2.不管是哪个子组,当MIC≤0.5mg/L时，0.5g/q6h输注超过6h方案的PTA>90％。1.0g/q6h输注方案与其他方案相比，在大多数情况下,制造PTA>90%的概率更高。对于低MIC的患者，0.5g/q6h输注超过6h可能是优选的。对于高MIC的患者，在6小时内输注1.0g/q6h的剂量方案可能是优选的。需要进一步的研究来证实这一探索性结果。
