蒙特卡罗模拟评价尿路大肠埃希菌感染的氟喹诺酮类给药方案

Evaluation of Fluoroquinolone Dosing Regimen for Urinary Escherichia Coli Infection Using Monte Carlo Simulation

目的根据抗菌药物的药动学/药效学(PK/PD)理论,应用蒙特卡罗模拟评价氟喹诺酮类药物在治疗尿路大肠埃希菌感染时,不同给药方案的疗效。方法对莫西沙星、左氧氟沙星和环丙沙星静脉给药方案治疗尿路大肠埃希菌(Escherichia coli)的效果进行蒙特卡罗模拟,将获得的累积反应分数(CFR)作给药方案的比较。结果静脉给予左氧氟沙星0.50 g qd、0.75 g qd的给药方案治疗尿路大肠埃希菌的CFR>90%,为有效的治疗方案;而莫西沙星0.40 g qd以及环丙沙星0.20 g q12 h、0.50 g q12 h的给药方案CFR<90%,不作为推荐给药方案。结论对于尿路大肠埃希菌感染,左氧氟沙星0.50 g qd、0.75 g qd为氟喹诺酮类药物的有效给药方案;莫西沙星、环丙沙星对尿路大肠埃希菌的效果不理想。

OBJECTIVE To estimate and optimize the dosage regimens of fluoroquinolones for urinary Escherichia Coli infection by Monte Carlo simulation（ MCS） based on PK/PD method. METHODS MCS was used to simulate different schedule of fluoroquinolones against Escherichia Coli of urinary tract,and the CFRs of those regimens were analyzed and compared. RESULTS The CFRs of levofloxacin（ 0.50 g qd or 0.75 g qd） against Escherichia Coli of urinary tract achieved 90%,but the CFRs of moxifloxacin（ 0.40 g qd） and ciprofloxacin（ 0.20 g q12 h or 0.50 g q12 h） were less than 90%. CONCLUSION For urinary Escherichia Coli infection,the optimal dosage regimens of levofloxacin is 0. 50 g qd or 0. 75 g qd. The regimens of moxifloxacin and ciprofloxacin is ineffective against Escherichia Coli of urinary tract.