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中国临床药理学与治疗学 ›› 2015, Vol. 20 ›› Issue (6): 677-681.

• 药物治疗学 • 上一篇    下一篇

PK/PD优化哌拉西林他唑巴坦给药方案治疗下呼吸道感染

章小敏,洪冰,叶军辉,叶爱菊,余贤广,徐梯,罗武军,费文晟   

  1. 浙江大学附属第一医院三门湾分院
  • 收稿日期:2014-09-12 修回日期:2015-03-08 出版日期:2015-06-26 发布日期:2015-06-29
  • 通讯作者: 章小敏 E-mail:smyyyjk@126.com
  • 基金资助:

    浙江省医学会临床科研基金项目;台州市科技计划项目

Optimized the Dosage Regimen of Piperacillin/Tazobactam in treatment of lower respiratory tract infections based on pharmacokinetics/pharmacodynamics

  • Received:2014-09-12 Revised:2015-03-08 Online:2015-06-26 Published:2015-06-29
  • Contact: Xiao-Min ZHANG E-mail:smyyyjk@126.com

摘要: 摘要 目的:评价时间依赖型抗菌药物哌拉西林/ 他唑巴坦(piperzcillin/ tazobactam,PIPC/TAZ)治疗下呼吸道感染,延长输注时间和持续输注与传统输注给药方案比较能否获得更高的临床疗效和细菌学疗效。方法:采用前瞻开放性随机对照研究方法,选择2013年1月~2014年3月间入住该院呼吸内科中、重度下呼吸道感染且致病菌对PIPC/TAZ敏感的患者200例,随机进入试验组和对照组各100例, 试验组给予PIPC/TAZ 3.0g/0.75g,q8h ,微泵静脉持续输注3h;对照组给予PIPC/TAZ 3.0g/0.75g,q8h,静脉滴注30min。比较2组治疗前后各观察指标的变化情况,治疗后临床疗效、细菌学疗效及不良反应评价。结果:治疗d4、d8实验室指标:白细胞计数、中性粒细胞比率、C-反应蛋白、血液氧分压,试验组与对照组组间比较P<0.01,差异有统计学意义。治疗d4、d8临床疗效比较,试验组总有效率分别为78.8%和90.9%,而对照组为58.6%和81.8%,2组分别比较差异均具统计学意义(P<0.01)。细菌清除率试验组与对照组分别为91.8%和78.9%, 2组比较P<0.05,差异具有统计学意义。试验组与对照组均未引起严重的药物不良反应,其不良反应发生率分别为2%和3%,差异无统计学意义(P>0.05)。结论:PIPC/TAZ微泵持续静脉输注3h治疗下呼吸道感染与传统输注给药方案比较,能获得更高的临床疗效和细菌学疗效,是时间依赖型抗菌药物更合理有效的给药方案。

Abstract: Abstract AIM:To evaluate the clinical efficacy and clearance rate of pathogens of piperacillin/tazobactam(PIPC/TAZ),time-dependent antibacterial,acquiring the therapy of extended-infusion and continuous infusion in treatment of patients with lower respiratory tract infection (LRTI), compared with traditional infusion therapy. METHODS:200 inpatients with moderate and severe LRTI in pulmonary department from Jan 2013 to Mar 2014 were randomly divided into experimental group and control group,100 cases each.The cultivated pathogenic bacteria was all susceptible to PIPC/TAZ.A prospective randomized controlled clinical trial was conducted.The patients in experimental group received PIPC/TAZ (3.0/0.75g) every 8h by continuous administration using minip- ump for 3h.By comparison,control group received PIPC/TAZ ( 3.0/0.75g ) every 8h by intravenous drip for 30 minutes.Changes of indexes were observed before and after the treatment,and also compared with the clinical effective rate,clearance rate of pathogens and adverse reaction rate after the treatment.RESULTS:The laboratory parameters in d4 and d8 were counted as follows.Differences between the two groups showed statistical significance(P<0.01) in white cell count, neutrophile granulocyte,C - reactive protein and blood oxygen partial pressure.Compared with the clinical effects in d4 and d8,the total effective rate of experimental group were 78.8% and 90.9% ,which were higher than those in control group(58.6% and 81.8% respectively).There was significant difference between the two groups(P<0.01).Meanwhile,the bacterial clearance rate of the two groups were 91.8% and 78.9%,respectively.The differences were statistically significant(P<0.05). Rates of adverse reactions in experimental group and control group were 2% and 3% respectively,without serious adverse reaction .No obvious statistical difference appeared( P > 0. 05).CONCLUSION:The continuous infusion of PIPC/TAZ by micro-pump for 3h is preferable compared with traditional infusion in treating LRTI,which was more reasonable and effective as time-dependent antibacterial.