Wu Yue-E, Xu Hai-Yan, Shi Hai-Yan, van den Anker John, Chen Xiao-Yu, Zhao Wei
Department of Clinical Pharmacy, Key Laboratory of Chemical Biology (Ministry of Education), School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, China.
Department of Neonatology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China.
Front Pharmacol. 2020 Sep 11;11:566060. doi: 10.3389/fphar.2020.566060. eCollection 2020.
Carbapenem-resistant enterobacteriaceae (CRE) bloodstream infections have been rapidly spreading worldwide with a high mortality and pose a challenge to therapeutic decision-making, especially in premature neonates because insufficient empirical antimicrobial therapy is independently associated with high mortality. This case reported that a premature infant with CRE bloodstream infection was treated successfully with high-dose meropenem treatment with model-based therapeutic drug monitoring (TDM). In clinical settings, treatment target attainment of meropenem can be improved by increasing the frequency of administration, prolonging the infusion time, and using a high dose. This case report shows a successful regimen for CRE infection in a premature neonate and emphasizes the utility of model-based TDM of high-dose meropenem treatment. The adequate antimicrobial benefit provided by innovative techniques could ensure the efficacy and safety of high-dose meropenem therapy for CRE infection.
耐碳青霉烯类肠杆菌科细菌（CRE）血流感染已在全球迅速蔓延，死亡率很高，对治疗决策构成挑战，尤其是在早产儿中，因为经验性抗菌治疗不足与高死亡率独立相关。本病例报告了一名患有CRE血流感染的早产儿通过基于模型的治疗药物监测（TDM）进行高剂量美罗培南治疗而成功治愈。在临床环境中，可通过增加给药频率、延长输注时间和使用高剂量来提高美罗培南的治疗目标达成率。本病例报告展示了一种针对早产儿CRE感染的成功治疗方案，并强调了基于模型的高剂量美罗培南治疗TDM的实用性。创新技术提供的充分抗菌效益可确保高剂量美罗培南治疗CRE感染的疗效和安全性。
