亚胺培南和左氧氟沙星治疗方案蒙特卡洛模拟的比较
Computers and Applied Chemistry(2009)
Abstract
依据抗菌药物的药动学/药效学原理,本文建立蒙特卡洛模拟模型,优化比较亚胺培南/西司他丁(剂量以亚胺培南计)和左氧氟沙星抗感染治疗的给药方案。模拟试验表明,亚胺培南0.5 g/8 h静脉滴注对鲍曼不动杆菌、肺炎克雷伯菌感染的疗效较好,累积反应分数(CFR)分别为97.28%和99.71%;对铜绿假单孢菌,低剂量的CFR不够理想,增大剂量可以提高CFR,但低于90%,提示经验治疗时须考虑联合用药。左氧氟沙星静脉滴注0.2g/d对卡他莫拉菌有效,CFR为100%;对肺炎克雷伯菌,0.2g/d、0.3 g/d、0.5g/d和0.75 g/d各治疗方案的CFRs相近,约为55%,增加剂量未能增强效果;对肺炎链球菌,0.5g/d的日剂量CFR达100%,可具有治疗效果。蒙特卡洛模拟可预测和优化抗菌药的用药设计,帮助临床选择合适的抗感染治疗方案。
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Key words
Monte Carlo simulation,imipenem,dosage regimen,levofloxacin,pharmacodynamics,pharmacokinetics
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