中华烧伤杂志
中華燒傷雜誌
중화소상잡지
16
2008年
2期
93-96
,共4页
张丽华%王凌峰%孟昭彦%于庆萍%高柏青%巴特%王晓冬%马文慧%李跃宇%张军
張麗華%王凌峰%孟昭彥%于慶萍%高柏青%巴特%王曉鼕%馬文慧%李躍宇%張軍
장려화%왕릉봉%맹소언%우경평%고백청%파특%왕효동%마문혜%리약우%장군
抗菌药%药代动力学%假单胞菌,铜绿%微生物敏感性试验%药效学
抗菌藥%藥代動力學%假單胞菌,銅綠%微生物敏感性試驗%藥效學
항균약%약대동역학%가단포균,동록%미생물민감성시험%약효학
Anti-bacterial agents%Pharmacokinetics%Pseudononas acruginosa%Microbial sensitivity tests%Pharmacodynamics
目的 了解环丙沙星、阿米卡星与抗铜绿假单胞菌的β内酰胺类药物体外联用的抗菌活性,优化抗生素治疗方案. 方法采用棋盘法设计,微量肉汤稀释法测定上述抗生素不同组合对33株临床分离的铜绿假单胞菌的最低抑菌浓度(MIC),判定联合效应,计算其药代动力学/药效学(PK/PD)参数. 结果阿米卡星与头孢他啶联用主要表现为协同作用,协同比率为57.6%;环丙沙星与头孢他啶、头孢毗肟、亚胺培南/西司他丁、美罗培南联用以协同和相加作用为主.氨基糖苷类和氟喹诺酮类抗生素,在PK/PD研究中,以血药浓度峰值(Cmax)/MIC为主要参数;β内酰胺类抗生素以血药浓度超过MIC的时间(T>MIC)为主要参数. 结论抗菌药物联用后,MIC显著降低,抗菌作用明显增强.所有抗生素的联用均以协同和相加作用为主,无拮抗作用.PK/PD研究,对制定合理给药方案、提高临床疗效具有晕要作用.
目的 瞭解環丙沙星、阿米卡星與抗銅綠假單胞菌的β內酰胺類藥物體外聯用的抗菌活性,優化抗生素治療方案. 方法採用棋盤法設計,微量肉湯稀釋法測定上述抗生素不同組閤對33株臨床分離的銅綠假單胞菌的最低抑菌濃度(MIC),判定聯閤效應,計算其藥代動力學/藥效學(PK/PD)參數. 結果阿米卡星與頭孢他啶聯用主要錶現為協同作用,協同比率為57.6%;環丙沙星與頭孢他啶、頭孢毗肟、亞胺培南/西司他丁、美囉培南聯用以協同和相加作用為主.氨基糖苷類和氟喹諾酮類抗生素,在PK/PD研究中,以血藥濃度峰值(Cmax)/MIC為主要參數;β內酰胺類抗生素以血藥濃度超過MIC的時間(T>MIC)為主要參數. 結論抗菌藥物聯用後,MIC顯著降低,抗菌作用明顯增彊.所有抗生素的聯用均以協同和相加作用為主,無拮抗作用.PK/PD研究,對製定閤理給藥方案、提高臨床療效具有暈要作用.
목적 료해배병사성、아미잡성여항동록가단포균적β내선알류약물체외련용적항균활성,우화항생소치료방안. 방법채용기반법설계,미량육탕희석법측정상술항생소불동조합대33주림상분리적동록가단포균적최저억균농도(MIC),판정연합효응,계산기약대동역학/약효학(PK/PD)삼수. 결과아미잡성여두포타정련용주요표현위협동작용,협동비솔위57.6%;배병사성여두포타정、두포비우、아알배남/서사타정、미라배남련용이협동화상가작용위주.안기당감류화불규낙동류항생소,재PK/PD연구중,이혈약농도봉치(Cmax)/MIC위주요삼수;β내선알류항생소이혈약농도초과MIC적시간(T>MIC)위주요삼수. 결론항균약물련용후,MIC현저강저,항균작용명현증강.소유항생소적련용균이협동화상가작용위주,무길항작용.PK/PD연구,대제정합리급약방안、제고림상료효구유훈요작용.
Objective To evaluate the antibacterial activity of Ciprofloxacin,Amikacin in combination with β-lactams against Pseudomonas aeruginosa strainS in vitro,to optimize treatment regime for antibiotics on the basis of pharnlacokinetics(PK)/pharmacodvnamics(PD)and drug sensitivity tests. Methods With checkerboard titration method,the minimal inhibitory concentrations(MIC)of a combination of antibiotics in different concentrations for 33 clinically isolated Pseudomonas aeruginosa strains were determined by broth dilUtion.Fractional inhibitory concentrations(FIC)were calculated for judging synergic effect of antibiotics. Results The combination of Amikacin and Ceftazidime showed synergic eftects(accounting for 57.6%).The combinations of Ciprofloxacin with Ceftazidime,Cefepime,Imipenem/Cilastatin,Meropenem showed svnergic or additive effect.In the study with PK/PD,Cmax/MIC was the principal parameters for evaluation of aminoglycoside and fluoroquinolone antibiotics,while T>MIC was the principal parameter to be used to evaluate β-lactams antibiotics. Conclusion When antibiotics are used in combination,MICs can be reduced significantly and antibacterial activities are enhanced remarkably.The combination of antibiotics results mainly in synergic or additive effect,and no inhibitory effect is observed.PK/PD analysis plays an important role in planning optimal combination regime to raise clinical efficacy.
