美洛培南的体外抗菌活性及其在烧伤患者体内的药动学研究

In Vitro Antibacterial Activity of Meropenem and Its Pharmacokinetics in Patients with Burn Injury

目的研究美洛培南的体外抗菌活性及其在烧伤患者体内的药动学。方法采用琼脂二倍稀释法测定美洛培南对136株临床分离菌的最小抑菌浓度(MIC)。28例烧伤患者静脉滴注美洛培南0.5g,测定其不同时间的血药浓度及尿药回收率等,用3p97软件计算药动学参数。结果美洛培南对肺炎克雷伯氏菌、肺炎球菌、阴沟肠杆菌的抗菌活性强,MIC90<0.0075~0.25μg/ml。药动学参数为t1/2α(0.35±0.12)h、t1/2β(2.10±0.71)h、AUC(44.62±12.95)μg/ml、Vc(10.6±3.93)L、CLs(12.00±3.04)L/h;6.5h后平均血药浓度(1.01±0.53)μg/ml,0h^12h尿回收率(58.1±16.8)%。结论美洛培南对本试验中受试菌有很强的抗菌活性,其在烧伤患者体内的主要药动学参数与健康志愿者有较大的差异。

OBJECTIVE： To study the antibacterial activity of meropenem in vitro and the pharmacokinetics of which in patients with burn injury. METHODS： The minimal inhibition concentration （MIC） of meropenem against 136 clinical isolates was determined with double agar dilution method. 28 patients with burn injury were given 0.5g of meropenem by iv gtt, with the blood concentration of meropenem and the recovery of meropenem in urine were determined at different time. The pharmacokinetics parameters were computed with 3p97 software. RESULTS： Meropenem showed a strong antibacterial activity against K.peneumoniae, pneumonococcus and Enterobacter cloacae. MICg0 was below 0.0 075-0.25μg/ml. Pharmacokinetics parameters of meropenem were the following： t 1/2α was （0.35±0.12） h, t 1/2β was （2.10± 0.71） h, A UC was （44.62±12.95） μg/ml, Ve was （10.60±3.93） L; CLs was （12.00±3.04） L/h. 6.5 hours later, the mean blood concentration was （ 1.01± 0.53）μg/ml; and the recovery of meropenem in 0h-12h urine was （58.06± 16.83） 96. CONCLUSIONS： Meropenem showed a very strong antibacterial activity in this study, there were significant differences regarding the in vivo pharmacokinetics parameters between the healthy volunteers and the patients with burn injury.