头孢哌酮钠舒巴坦钠微泵3 h静脉给药的临床疗效和经济学评价

Clinical efficacy and economic evaluation of Cefoperazone Sodium and Sulbactam Sodium injection using micro-pumps for 3 hours

目的探索头孢哌酮钠舒巴坦钠(舒普深)同一剂量、不同给药方案的抗菌强度差异。方法计算每次静脉滴注0.5 h完成与延时给药(2 h、3 h)的头孢哌酮钠血药浓度(C)和药动学药效学(PK/PD)参数(%T>MIC),评价临床疗效和药物经济学成本。结果①3 h终点药物浓度:同一剂量(1 g),延时2 h和3 h组是0.5 h组的140.3%(40.0/28.5)、179.2%(51.1/28.5);②抗菌强度(%T>MIC)增幅:a.同剂量,不同给药间隔,每次均静滴0.5 h:q8 h、q6 h组较q12 h组增幅50%、100%;b.同剂量,不同给药间隔,不同给药时间:q12 h组:延时(2 h、3 h),较0.5 h、增幅为14%;11.7%;q8 h组:增幅为13.8%、20.9%;c.(q6 h)(延时2 h、3 h)比(q12 h、0.5 h)增幅分别为207%、234.9%;d.同一日剂量(4.0 g)(%T>MIC)值:(1.0 g,q6 h,延时2 h、3 h),较(2.0 g,q12 h,0.5 h)增加50%~70%;③达同一抗菌强度,增加给药次数,辅助延时给药,医药成本下降1/3:(1.0 g,q8 h,延时2.0 h)(%T>MIC)=61.2,较(2 g,q12 h,0.5 h)日剂量4.0 g(%T>MIC=60.0),减少日剂量1/3。结论舒普深增加给药次数,联合延时给药3 h,提高抗菌强度,节约医药成本,为重症感染患者,超说明书用药,提供了药动学药效学理论依据。

Objective Explore the difference antibacterial effect of Cefoperazone Sodium and Sulbactam Sodium in the same dose and different administration schemes.Methods The terminal drug concentration(C)of cefoperazone sodium and its pharmacokinetic and pharmacodynamic(PK/PD)(%T>MIC)were calculated after 0.5 h intravenous infusion and delayed administration(2 h,3 h),and the clinical efficacy and pharmacoeconomic cost were evaluated.Results①The 3-hour end-point drug concentration:the same dose(1 g),delayed 2 h and 3 h groups were 140.3%(40.0/28.5)and 179.2%(51.1/28.5)of the 0.5 h group.②The increase of antibacterial strength(T>MIC)was as follows:a.the same dose and different administration interval were given intravenously for 0.5 h:q8 h and q6 h groups increased by 50%and 100%compared with q12 h group;b.At the same dose,different administration interval and different administration time:q12 h group:delay time(2 h,3 h),increased by 14%;11.7%;q8 h group:increased by 13.8%and 20.9%;c.(q6 h)(delay 2 h,3 h)was 207%and 234.9%,higher than that of q12 h and 0.5 h,respectively;d.The same day dose(4.0 g)(%T>MIC)value:(1.0 g,q6 h,delayed 2 h,3 h),compared with(2.0 g,q12 h,0.5),increased by 50%~70%.③The cost of medicine decreased by1/3:(1.0 g,q8 h,2.0 h)(%T>MIC)=61.2,compared with(2 g,q12 h,0.5 h),the daily dose of 4.0 g(%T>MIC=60.0)was reduced by 1/3.Conclusion When increased the number of administration,combined with delayed administration of Cefoperazone Sodium and Sulbactam Sodium for 3 h,it can improve the antibacterial strength and saved the cost of medicine.It provided the theoretical basis of PK/PD for patients with severe infection and off label medication.