against Gramnegative bacteria collected from Shenyang,英文资料.pdfVIP

Chu et al. BMC Infectious Diseases 2010, 10:171 /1471-2334/10/171 R E S E A R C H A R T I C L E Open Access Research article Pharmacokinetic-pharmacodynamic profiling of four antimicrobials against Gram-negative bacteria collected from Shenyang, China 1 1 †2 1 †1 1 Yun Zhuo Chu , Su Fei Tian , Bai Yi Chen* , Hua Nian , Hong Shang and Guo Quan Sun Abstract Background: To examine common antimicrobial regimens used in eradicating certain nosocomial Gram-negative pathogens and determine which ones are likely to be the most suitable as empirical choices in Shenyang, China. Methods: A 5000-subject Monte Carlo simulation was conducted to determine the cumulative fraction of response (CFR) for meropenem, imipenem, cefepime, piperacillin/tazobactam and levofloxacin against Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Acinetobacter baumannii and Pseudomonas aeruginosa collected in 2006 and 2007 from Shenyang. Results: Meropenem and imipenem had the highest CFRs against the Enterobacteriaceae (97%-100%), followed by cefepime. No antibiotic simulated regimen achieved optimal CFR against P. aeruginosa and A. baumannii . Piperacillin/ tazobactam dosed at 4.5 g q8h achieved the lowest CFR against all bacteria. Conclusions: This study suggests that the carbapenems provide the greatest likelihood of clinical success for the Enterobacteriaceae, and combination therapy might be needed when choosing empirical therapy, especially when A. baumannii or P. aeruginosa are suspected. Background namic (PK/PD) models with Monte Carlo simulation The rapid increase in the prevalence of multidrug resis- offers a more use