延长美罗培南输液时间治疗铜绿假单胞菌的疗效评价.docVIP

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I马绽梅方向华 摘要：目的：评估延长美罗培南输注时间治疗屮重症铜绿假单抱菌患者的疗效及安全性，探 索求证小剂量美罗培南延长治疗时间是否能达到大剂量短时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，获得知情同意书丿随机为3组：1.0gq8h30min组、l.Og q8h 3 h组和0.5g q8h 3 h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生素临 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发生率计算。结果：给药 72h后，1 .Og q8h 3 h组与l.Og q8h 30 min纟H.相比，体温下降较大，停药当天比较，临床有效 率及细菌清除率也有提高(P值均0.05)。给药72h后，0.5g q8h 3 h组与1.0gq8h30min 组Z间体温变化值没有显著性弟异(P0.05):停药当天，这两组Z间临床有效率没有显 著性差异(P0.05),而且细菌清除率也没有显著性并异(P0.05)。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血优于持续 点滴30分钟给药方式。以持续点滴3小时的方式每8小时应用美罗培南500mg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1.0 g相比至少有可比性。 关键词：美罗培南；铜绿假单胞菌；治疗； Efficacy and Safety of Extending the Adminstration Time of Meropenem inTreatment of Pseudomonas aeruginosa Infections Lu Zhuju Abstract: OBJECTIVE To compare the outcomes and safety of extending the administration time of meropenem infiision in patients with pseudomonas aemginosa infections and without renal dysfunction. METHODS Selected 45 patients with pseudomonas aemginosa infections and without renal dysfunction in our hospital from June 2009 to September 2010, and randomly divided into three groups, l.Og q8h 30 min group, l.Og q8h 3 h group and 0.5g q8h 3 h group, the l.Og q8h 30 min groups scheme was meropenem lg iv drip Q8h inflised over 30min; the l.Og q8h 3h groups scheme was meropenem lg iv drip Q8h infused over 3h; and the 0.5g q8h 3 h groups scheme was meropenem 500mg iv drip Q8h infused over 3h. The efficacy primary endpoints were changes of body temperature and white blood cell count of 72 hours after meropenem administration. Efficacy secondary endpoints included antibiotic clinical efficacy and bacteriological efficacy. Safety assessments in eluded adverse events and the occurrence of adverse reaction rate calculation. RESULTS In 72 hours after meropenem administration, compared withl.Og Q8H 30 min group, l.Og Q8H 3 h groups temperature decreased, the clinical efficiency and bacterial clearance rate increased (P 0.