蒙特卡洛模拟法优化舒巴坦在重症连续性静脉-静脉血液滤过患者的给药方案研究
Optimization of sulbactam regimens in intensive care unit continuous veno-venous hemofiltration patients with Monte Carlo simulation method
李颖 1余佩 2薛飞 1陈敏纯 1王登 1董亚琳3
作者信息
- 1. 西北大学附属医院西安市第三医院药剂科,西安 710021
- 2. 西安外事学院,西安 710077
- 3. 西安交通大学第一附属医院药学部,西安 710061
- 折叠
摘要
目的 利用蒙特卡洛模拟法优化舒巴坦在重症连续性静脉-静脉血液滤过患者中的给药方案.方法 收集舒巴坦在重症连续性静脉-静脉血液滤过患者的药动学/药效学(PK/PD)参数与鲍曼不动杆菌最低抑菌浓度(MIC),进行5 000次蒙特卡洛模拟,评估给药方案的合理性.鲍曼不动杆菌的PK/PD靶值为40％fT＞MIC和60％fT＞MIC.结果 对于鲍曼不动杆菌引起的重症连续性静脉-静脉血液滤过患者,当MIC=4 mg-L-1时,推荐给药方案分别为0.5 h传统静脉输注1 g,q8h和1 g,q6h.在2种PK/PD靶值下推荐的经验性给药方案分别是24 h连续性静脉输注9 g,q24h和12 g,q24h.结论 针对敏感率较低的鲍曼不动杆菌菌株,推荐采用3 h延长静脉输注或24 h连续性静脉输注的给药方案.
Abstract
AIM To optimize sulbactam regimens for intensive care unit(ICU)continuous veno-venous hemofiltration(CVVH)patients using the Monte Carlo simulation method.METHODS Pharmacokinetic/pharmacodynamic(PK/PD)parameters of sulbactam in ICU CVVH patients and the minimum inhibitory concentration(MIC)of Acinetobacter baumannii(AB)were collected.Monte Carlo simulations(n=5 000)were conducted to assess the rationality of the dosing regimen.The PK/PD target values for AB were 40％fT＞MIC and 60％fT＞MIC.RESULTS For ICU patients with CVVH caused by AB,when the MIC was 4 mg·L-1,the recommended dosing regimens were traditional intravenous infusions of 1 g,q8h and 1 g,q6h(with each dose infused over 0.5 h).The empiric dosing regimens recommended under 2 PK/PD target values were 24-hour continuous intravenous infusion of 9 g,q24h and 12 g,q24h.CONCLUSION It is recommended to use either a 3-hour extended intravenous infusion or a 24-hour continuous intravenous infusion regimen for the treatment of AB strains with lower susceptibility.
关键词
药动学/药效学/舒巴坦/蒙特卡洛模拟/重症/血液滤过/鲍曼不动杆菌Key words
pharmacokinetic/pharmacodynamic/sulbactam/Monte Carlo method/continuous venovenous hemofiltration/Acinetobacter baumannii引用本文复制引用
基金项目
陕西省自然科学基础研究计划青年项目(2019JQ-475)
西安市第三医院国科金青年培训项目(Y2023qn0008)
出版年
2024
国家科技期刊平台
NSTL
万方数据