CAJ | 학술논문

依据抗菌药物的药动学/药效学原理,本文建立蒙特卡洛模拟模型,优化比较亚胺培南/西司他丁(剂量以亚胺培南计)和左氧氟沙星抗感染治疗的给药方案.模拟试验表明,亚胺培南0.5 g/8 h静脉滴注对鲍曼不动杆菌、肺炎克雷伯菌感染的疗效较好,累积反应分数(CFR)分别为97.28%和99.71%;对铜绿假单孢菌,低剂量的CFR不够理想,增大剂量可以提高CFR,但低于90%,提示经验治疗时须考虑联合用药.左氧氟沙星静脉滴注0.2 g/d对卡他莫拉菌有效,CFR为100%;对肺炎克雷伯菌,0.2 g/d、0.3 g/d、0.5 g/d和0.75 g/d各治疗方案的CFRs相近,约为55%,增加剂量未能增强效果;对肺炎链球菌,0.5 g/d的日剂最CFR达100%,可具有治疗效果.蒙特卡洛模拟可预测和优化抗菌药的用药设计,帮助临床选择合适的抗感染治疗方案.
의거항균약물적약동학/약효학원리,본문건립몽특잡락모의모형,우화비교아알배남/서사타정(제량이아알배남계)화좌양불사성항감염치료적급약방안.모의시험표명,아알배남0.5 g/8 h정맥적주대포만불동간균、폐염극뢰백균감염적료효교호,루적반응분수(CFR)분별위97.28%화99.71%;대동록가단포균,저제량적CFR불구이상,증대제량가이제고CFR,단저우90%,제시경험치료시수고필연합용약.좌양불사성정맥적주0.2 g/d대잡타막랍균유효,CFR위100%;대폐염극뢰백균,0.2 g/d、0.3 g/d、0.5 g/d화0.75 g/d각치료방안적CFRs상근,약위55%,증가제량미능증강효과;대폐염련구균,0.5 g/d적일제최CFR체100%,가구유치료효과.몽특잡락모의가예측화우화항균약적용약설계,방조림상선택합괄적항감염치료방안.
The Monte Carlo simulation models were built to compare and optimize the dosage regimens of imipenem/cilastatin(dose toimipenem)and levofloxacin for anti-infective therapy,based on the antibiotic pharmacokinetics/pharmacodynamics theory.The simula-tion results showed that the effect of 0.5 g/8 h imipenem by intravenous infusion was better for Acinetobacter baumannii and Klebsiellapneumonius infection,the cumulative fraction of response(CFR)was 97.28%and 99.71%respectively;For Pseudomonas aerugino-sa,the CFRs of lower doses of imipenem was not satisfied,and the CFR could be improved with the increased dose,but less than90%,which suggested that the combined use of drugs should be considered in the empirical therapy.In levofloxacin,the effect of 0.2g/d intravenous infusion against Moraxella catarrhalis Was good with 100%CFR.For Klebsiella pneumonius,the CFRs of 0.2 g/d,0.3 g/d,0.5 g/d and 0.75 g/d were similar,about 55%.The effectiveness could not be improved with the increased doses.ForStreptococcus pneumonius,0.5 g daily dose wag effective with 100%CFR.Monte Carlo simulation can predict and optimize the antibi-otic dosage design,and help to select the appropriate regimen for chnical anti-infective treatment.