治疗多重耐药铜绿假单胞菌败血症性休克的最佳美罗培南浓度。
Optimal meropenem concentrations to treat multidrug-resistant Pseudomonas aeruginosa septic shock.
机构信息
Department of Intensive Care, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium.
出版信息
Antimicrob Agents Chemother. 2012 Apr;56(4):2129-31. doi: 10.1128/AAC.06389-11. Epub 2012 Jan 30.
Abstract
A patient with septic shock due to extensively drug resistant (XDR) Pseudomonas aeruginosa was cured by optimizing the meropenem (MEM) regimen to obtain at least 40% of the time between two administrations in which drug levels were four times higher than the MIC of the pathogen. As the standard drug dose did not achieve these optimal concentrations, the MEM regimen was progressively increased up to 12 g/day (3 g every 6 h in a 3-h extended infusion), which eventually resulted in sepsis resolution. High MEM dosage may represent a valuable therapeutic option for infection due to multidrug-resistant (MDR) strains, and drug monitoring would allow rapid regimen adjustment in clinical practice.
摘要
一名患有广泛耐药（XDR）铜绿假单胞菌败血症性休克的患者通过优化美罗培南（MEM）方案得到治愈，该方案使两次给药之间药物浓度高于病原体 MIC 的时间至少达到 40%，从而使药物浓度达到 4 倍。由于标准药物剂量无法达到这些最佳浓度，因此逐渐增加 MEM 方案剂量直至 12 g/天（3 g 每 6 小时延长输注 3 小时），最终导致败血症得到解决。高剂量 MEM 可能代表对多药耐药（MDR）菌株感染的有价值的治疗选择，药物监测可在临床实践中快速调整方案。
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