蒙特卡罗模拟优化CRKP感染时美罗培南的给药方案

Optimization of medication strategy of meropenem for CRKP infection by Monte Carlo simulation

目的依据美罗培南PK/PD理论,优化美罗培南治疗CRKP感染的给药方案。方法借助文献中美罗培南的药代动力学参数,应用Crystal Ball软件对美罗培南不同给药方案进行50000次模拟,比较不同方案治疗耐碳青霉烯类肺炎克雷伯杆菌感染的达标率,优选最佳给药方案。结果设定的10种方案中,只有0.5 g(q3h)、0.5 g(q4h)静脉滴注给药方案有达标的可能性,CFR分别为4.85%和29.52%,低于目标值90%;2种持续静脉输液2、2.5、3 h,PTA、CFR均大于90%;MIC和半衰期在模拟预测影响因素约占40%。结论治疗CRKP可选择0.5 g(q3h)和0.5 g(q4h)给药方案,且持续静脉滴注2、2.5、3 h。

Objective To optimize the dosage regimen of meropenem for CRKP infection,based on meropenem PK/PD theory.Methods The different dosage regimen was simulated for 50000 times by using Crystal Ball software,with the help of the pharmacokinetic parameters.The target rates of different regimens for treating CRKP were compared,and the regimen was optimized.Results The regimens of 0.5 g(q3 h)and 0.5 g(q4 h)intravenous drip were likely to get the target in the set 10 regimens,and the CFR was 4.85%and 29.52%,which was lower than 90%target value.The PTA and CFR were more than 90%when the duration of intravenous infusion drip was 2 h,2.5 h and 3 h.The influence factors of MIC and half-life in the simulation prediction accounted for about 40%.Conclusion Drug delivery regimen of 0.5 g(q3 h)and 0.5 g(q4 h)with continuous intravenous infusion for 2 h,2.5 h and 3 h can be used in the treatment of CRKP.