Evaluation and Optimization of the Treatment Regimen of Pseudomonas Aeruginosa Infection with Carbapenems in Our Hospital Based on Monte Carlo Simulation
Evaluation and Optimization of the Treatment Regimen of Pseudomonas Aeruginosa Infection with Carbapenems in Our Hospital Based on Monte Carlo Simulation
Objective To evaluate the efficacy of three antibacterial agents in the treatment of Pseudomonas aerugino-sa infection by Monte Carlo simulation combined with the pharmacokinetic/pharmacodynamic models of Meropenem,Imipenem and Biapenem.Methods The minimum inhibitory concentration(MIC)of Pseudomonas aeruginosa isolated from clinical specimens from 2018 to 2021 was measured.For patients treated with carbapenems,Monte Carlo simulation was used to simu-late the probability of target attainment(PTA)and cumulative fraction of response(CFR)of target f%T＞MIC≥40%for 5 000 infections of Pseudomonas aeruginosa with different treatment regimens.Results A total of 71 patients were collected,among whom the resistance rate of Pseudomonas aeruginosa to Meropenem was26.76%.For the distribution of MIC values in our hospital,the CFR of carbapenem antibiotics was less than90%.When MIC was≤1 mg/L,PTA was＞90%in all ad-ministration regimens,and when MIC was≥8 mg/L,PTA was＜90%in all administration regimens.The sensitive correla-tion of MIC values of the three antibacterial agents ranged from-73.52%to-88.78%.Conclusion Carbapenem antibiot-ics can be used to treat relatively sensitive PA infection with conventional dose,while carbapenem resistant Pseudomonas aeruginosa infection should be treated with increased dose and frequency of administration or combined administration.Bacteri-al culture should be emphasized in clinical treatment,and treatment regimen should be formulated according to MIC value.
Infection/Pseudomonas aeruginosa/Monte Carlo simulation/Carbapenems/Pharmacokinetics/pharma-codynamics/Minimum inhibitory concentration/Probability of target attainment/Cumulative fraction of response
维普
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