应用蒙特卡罗模拟法优化产ESBLs肠杆菌感染的拉氧头孢给药方案

Optimization of Latamoxef Regimens for ESBLs-producing Enterbacteriaceae Infection by Monte-carlo Simulation Method

目的:评估拉氧头孢抑制产超广谱β-内酰胺酶(ESBLs)菌株的活性,优化其给药方案。方法:收集产ESBLs的菌株,采用肉汤稀释法测定最低抑菌浓度(MIC),通过蒙特卡罗模拟(MCS)法评估了拉氧头孢每个稳定状态下游离药物浓度(%fT>MIC)的目标达成概率。结果与结论:根据MCS结果,在70%fT>MIC获得80%目标达成率的有效给药方案是:每12小时输注1g剂量,输注时间超过3～4h,用于抗大肠杆菌;每8小时输注1g剂量,输注时间超过2～4h,用于抗肺炎克雷伯菌。

OBJECTIVE： To evaluate latamoxef inhibiting the activity of Extended spectrum-β-lactamase （ESBLs）-producing strains, and to optimize the medication regimens. METHODS： ESBLs-producing strains were collected and MIC of them was deter- mined by broth dilution method. The probability of each %fT〉M,c goals of latamoxef was evaluated with Monte-carlo simulation method （MCS）. RESULTS ＆ CONCLUSION： According to MCS results, the effective medication regimen with 70%fT〉MIC of 80% target yield rate was as follows： infusing 1 g every 12 hours, infusing for more than 3-4 h, resisting to Escherichia coli; in- fusing 1 g every 8 hours, infusing for more than 2-4 hours, resisting Klebsiella pneumoniae.