延长美罗培南输注时间治疗重症肺炎的临床研究

Clinical Study of Prolonged Intravenous Infusion of Meropenem in the Treatment of Severe Pneumonia

目的:研究美罗培南延长输注法与传统输注法在治疗重症肺炎疗效上的差异。方法:采用蒙特卡罗模型模拟两种方法可能取得的药动学/药效学方面的差异。选取50例重症肺炎患者分成A、B组,各25例。A组采取美罗培南1.0 g,q8 h,输注30 min;B组采取美罗培南0.5 g,q8 h,延长输注3 h。比较两组在临床治疗成功率、治疗成功平均疗程、治疗成功平均成本方面的差异。结果:A、B组治疗成功率分别为72%、76%(P>0.05),治疗成功平均疗程分别为(7.2±1.4)d、(6.3±0.8)d(P<0.05),治疗成功平均成本分别为(6 578±345)、(4 756±287)元(P<0.05)。结论:对于敏感或者中介的病原菌引起的重症肺炎可以使用延长输注法,能够减少治疗成本和缩短治疗时间。

OBJECTIVE： To study the differences of efficacy between prolonged and traditional intravenous infusion of me- ropenem in the treatment of severe pneumonia. METHODS： The differences of pharmacokinetic/pharmacodynamic （PK/PD） be- tween 2 methods were simulated by Monte Carlo model. Totally 50 patients with severe pneumonia were divided into group A and B, 25 for each. Group A was given meropenem 1.0 g, q8 h, intravenous infusion for 30 min; group B was given meropenem 0.5 g, q8 h, intravenous infusion for 3 h. The differences among the rate of treatment success, average treatment success course and av- erage treatment success cost in 2 groups were compared. RESULTS ： The rate of treatment success in group A and B was respective- ly 72% and 76% （P〉0.05）, the average treatment success course was respectively （7.2＋1.4） d and （6.3＋0.8） d （P〈0.05） and the average treatment success cost was respectively （6 578＋345） yuan and （4 756＋287） yuan （P〈0.05）. CONCLUSIONS： The se- vere pneumonia induced by sensitive or intermediary pathogens can be treated by prolonged intravenous infusion of meropenem and it can reduce the cost and shorten the treatment time.