基于Excel函数设计抗菌药物间歇静脉滴注给药方案

Excel-based Design of Intermittent Intravenous Drip Dose Regimen of Antibiotics

目的:设计抗菌药物间歇静脉滴注给药方案。方法:以头孢唑啉钠、头孢曲松钠、阿米卡星为例,采用多剂量函数法处理相关药动学数据,将药动学与药效学(PK/PD)参数相结合,应用Excel软件编写计算程序,设计合理给药方案。结果:时间依赖性抗菌药物的杀菌效应主要取决于血药浓度高于细菌最低抑菌浓度(MIC)的时间;对于血浆消除半衰期短的抗菌药物宜采取小剂量均匀分次给药,甚至持续给药;半衰期较长者12～24h给药1次即可。浓度依赖性抗菌药物优化临床抗菌疗效的最佳PK/PD参数为Cmax/MIC,适宜日剂量单次给予。结论:基于PK/PD,应用Excel函数设计抗菌药物间歇静脉滴注给药方案,方法简便、可靠、直观。

OBJECTIVE： To design intermittent intravenous drip dose regimen of antibiotics. METHODS： The pharmacokinetic data were computed using the multidoses function method taking cefazolin, ceftriaxone and amikacin as examples. Then computation program was programmed using Excel software based on pharmacokinetic parameters combined with pharmacodynamic parameters to design rational dosage regimen. RESULTS： The bactericidal effect of time- dependent antibiotics was chiefly dependent on the time during which the drug blood concentration was higher than minimal inhibitory concentration （MIC） .For those antibacterials with short elimination half life（t 1/2）in plasma, the best regimen was to give patients the medicine in a small average divided dose or continuous medication. For those with（t 1/2） greater than 12--24 h, single dose administration was advisable. For concentration-dependent antibiotics, the best PK/ PD parameters for optimal clinical antibiotic effect were Cmax/ M IC, and which should be administered in single time （daily dose）. CONCLUSION： PK/PD parameters - based intermittent intravenous drip dosage regimen of antibiotics designed by means of Excel function is simple, reliable and intuitionistic.