延长美罗培南输液时间治疗铜绿假单胞菌的疗效评价

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1、延长美罗培南输液时间治疗铜绿假单胞菌的疗效评价卢竹菊1马绽梅方向华摘要：目的：评估延长美罗培南输注吋间治疗中重症铜绿假单孑包菌患者的疗效及女全性，探索求证小剂量美罗培南延长治疗吋间是否能达到人剂量短吋间输注模式类似的临床疗效。方法：纳入45例符合标准的患者，获得知情同意书后，随机为3组：1.0gq8h30min组、l.Ogq8h3h组和0.5gq8h3h组，每组各15例患者，观察两组患者的临床疗效及治疗期间的不良反应。首要疗效标准为给药72h后体温及白细胞计数的变化。次要疗效标准包括抗牛•素临床疗效及细菌学疗效。安全性评佔包括不良事件观察及不良反应

2、发生率计算。结果：给药72h后，1.0gq8h3h组与l.Ogq8h30min组相比，体温下降较人，停药当天比较，临床有效率及细菌清除率也有提高（P值均V0.05）。给药72h后,0.5gq8h3h组与l.Ogq8h30min组Z间体温变化值没有显著性差异（P>0.05）:停药当天，这两组Z间临床有效率没有显著性差异（P>0.05）,而H•细菌清除率也没冇显著性差异（P>0.05）o结论：采用传统l.Og剂量时，持续点滴3小时给药方式对体温的控制、临床治疗疗效以及细菌清除方面优于持续点滴30分钟给药方式。以持续点滴3小吋的方式侮8小吋应用美罗培南5

3、00mg与以持续点滴30分钟的方式每8小时应用较为传统的剂量美罗培南1.0g相比至少有可比性。关键词：美罗培南；铜绿假单胞菌；治疗；EfficacyandSafetyofExtendingtheAdminstrationTimeofMeropeneminTreatmentofPseudomonasaeruginosaInfectionsLuZhujuAbstract:OBJECTIVETocomparetheoutcomesandsafetyofextendingtheadministrationtimeofmeropeneminfusioninp

4、atientswithpseudomonasaemginosainfectionsandwithoutrenaldysfunction.METHODSSelected45patientswithpseudomonasaeruginosainfectionsandwithoutrenaldysfunctioninourhospitalfromJune2009toSeptember2010,andrandomlydividedintothreegroups,l.Ogq8h30mingroup,l.Ogq8h3hgroupand0.5gq8h3hgrou

5、p,thel.Ogq8h30mingroup'sschemewasmeropenemlgivdripQ8hinfusedover30min;thel.Ogq8h3hgroup'sschemewasmeropenemlgivdripQ8hinfusedover3h;andthe0.5gq8h3hgroup'sschemewasmeropenem500mgivdripQ8hinfusedover3h.Theefficacyprimaryendpointswerechangesofbodytemperatureandwhitebloodcellcount

6、of72hoursaftermeropenemadministration.Efficacysecondaryendpointsincludedantibioticclinicalefficacyandbacteriologicalefficacy.Safetyassessmentsincludedadverseeventsandtheoccurrenceofadversereactionratecalculation.RESULTSIn72hoursaftermeropenemadministration,comparedwithl.OgQ8H3

7、0mingroup,l.OgQ8H3hgroupstemperaturedecreased,theclinicalefficiencyandbacterialclearancerateincreased(P<0.05).In72hoursaftermeropenemadministrationandwithdrawalday,therewasnosignificantdifferencebetweenthechangesoftemperaturein0.5gQ8H3hgroupandl.OgQ8H30mingroup(P>0.05),andnosi

8、gnificantdifferenceintherateof1通讯作者(第一作者)：卢竹菊，主管护师，浙江省东阳市人民医院