| 引用本文: | 王莹,姚银辉,胡久丽.基于PK/PD模型和蒙特卡罗模拟的医院获得性大肠埃希菌泌尿系统感染基础治疗方案[J].中国现代应用药学,2020,37(17):2133-2137. |
| WANG Ying,YAO Yinhui,HU Jiuli.Basic Treatment of Hospital-acquired Escherichia Coli Urinary Tract Infection Based on PK/PD Model and Monte Carlo Simulation[J].Chin J Mod Appl Pharm(中国现代应用药学),2020,37(17):2133-2137. |
|
| 摘要: |
| 目的 应用药动/药效（pharmacokinetic/pharmacodynamic，PK/PD）模型和蒙特卡罗模拟优化医院获得性大肠埃希菌泌尿系统感染初始治疗方案。方法 筛选于2017年和2018年收治的医院获得性大肠埃希菌泌尿系感染患者作为研究对象，分别作为2017年组（42例）、2018年组（40例），选择左氧氟沙星、头孢唑林、阿米卡星、头孢他啶、环丙沙星、哌拉西林/他唑巴坦6种抗菌药物进行PK/PD模型和蒙特卡罗模拟，计算并比较2年的累积反应分数（cumulative fraction of response，CFR）以优化出最佳初始治疗方案。结果 2017年组的头孢他啶（2 000 mg，bid）、头孢唑林（1 000 mg，tid）、哌拉西林/他唑巴坦（4 500 mg，qid，PI）以及阿米卡星（400 mg，qd）的CFR分别为100.0%，94.27%，88.02%，90.89%，2018年组上述4种抗菌药物的CFR分别为81.52%，92.88%，82.58%，88.69%，相比2017年分别下降18.48%，1.39%，5.44%，2.20%，头孢唑林（1 000 mg，tid）CFR下降程度最小。结论 头孢唑林（1 000 mg，tid）可以作为医院获得性大肠埃希菌泌尿系感染优化后的最佳初始治疗方案，阿米卡星（400 mg，qd）、哌拉西林/他唑巴坦（4 500 mg，qid，PI）以及头孢他啶（2 000 mg，bid）对该病的治疗疗效较佳，可以作为备选给药方案。 |
| 关键词: 药动/药效模型 蒙特卡罗模拟 医院获得性泌尿系统感染 大肠埃希菌 治疗方案 |
| DOI：10.13748/j.cnki.issn1007-7693.2020.17.016 |
| 分类号:R969.4 |
| 基金项目:承德市科学技术研究与发展计划项目（201701A086） |
|
| Basic Treatment of Hospital-acquired Escherichia Coli Urinary Tract Infection Based on PK/PD Model and Monte Carlo Simulation |
|
WANG Ying, YAO Yinhui, HU Jiuli
|
|
Department of Pharmacy, Affiliated Hospital of Chengde Medical College, Chengde 067000, China
|
| Abstract: |
| OBJECTIVE To optimize the initial treatment plan for hospital-acquired Escherichia coli urinary tract infection by using pharmacokinetic/pharmacodynamic(PK/PD) model and Monte Carlo simulation. METHODS Screening patients with urinary tract infection of hospital-acquired Escherichia coli in hospital in 2017 and 2018 were selected as the 2017 group (42 cases) and 2018 group (40 cases), and six antibiotics including levofloxacin, cefazolin, amikacin, ceftazidime, ciprofloxacin, piperacillin/tazobactam were selected for PK/PD model and Monte Carlo simulation. The cumulative fraction of response (CFR) for two years were calculated and compared to optimize the optimal initial treatment regimen. RESULTS In the 2017 group, the CFR of ceftazidime (2 000 mg, bid), cefazolin (1 000 mg, tid), piperacillin/tazobactam (4 500 mg qid, PI), amikacin (400 mg, qd) was 100.0%, 94.27%, 88.02%, and 90.89%, respectively. In the 2018 group, the CFR of the above 4 antibiotic drugs were 81.52%, 92.88%, 82.58%, and 88.69%, respectively, which was 18.48%, 1.39%, 5.44%, and 2.20% lower than that in 2017, respectively. And cefazolin(1 000 mg, tid) had the lowest CFR reduction. CONCLUSION Cefazolin (1 000 mg, tid) can be used as the best initial treatment for the optimization of urinary tract infection in hospital-acquired Escherichia coli. amikacin (400 mg, qd), piperacillin/tazobactam (4 500 mg, qid) and ceftazidime (2 000 mg twice daily) are acceptable and can be used as a preparation choose a dosing regimen. |
| Key words: pharmacokinetic/pharmacodynamic model Monte Carlo simulation hospital-acquired urinary tract infection Escherichia coli treatment plan |
