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重症患者静脉推注与延长输注美罗培南的回顾性分析

A Retrospective Analysis of Intravenous Push versus Extended Infusion Meropenem in Critically Ill Patients.

作者信息

Johnson Emory G, Maki Ortiz Kayla, Adams David T, Kaur Satwinder, Faust Andrew C, Yang Hui, Alvarez Carlos A, Hall Ronald G

机构信息

Texas Health Presbyterian Hospital Dallas, Dallas, TX 75231, USA.

Health Sciences Center, Jerry H. Hodge School of Pharmacy, Texas Tech University, Dallas, TX 75235, USA.

出版信息

Antibiotics (Basel). 2024 Sep 2;13(9):835. doi: 10.3390/antibiotics13090835.

Abstract

Meropenem is a broad-spectrum antibiotic used for the treatment of multi-drug-resistant infections. Due to its pharmacokinetic profile, meropenem's activity is optimized by maintaining a specific time the serum concentration remains above the minimum inhibitory concentration (MIC) via extended infusion (EI), continuous infusion, or intermittent infusion dosing strategies. The available literature varies regarding the superiority of these dosing strategies. This study's primary objective was to determine the difference in time to clinical stabilization between intravenous push (IVP) and EI administration. We performed a retrospective pilot cohort study of 100 critically ill patients who received meropenem by IVP ( = 50) or EI ( = 50) during their intensive care unit (ICU) admission. There was no statistically significant difference in the overall achievement of clinical stabilization between IVP and EI (48% vs. 44%, = 0.17). However, the median time to clinical stability was shorter for the EI group (20.4 vs. 66.2 h, = 0.01). EI administration was associated with shorter hospital (13 vs. 17 days; = 0.05) and ICU (6 vs. 9 days; = 0.02) lengths of stay. Although we did not find a statistically significant difference in the overall time to clinical stabilization, the results of this pilot study suggest that EI administration may produce quicker clinical resolutions than IVP.

摘要

美罗培南是一种用于治疗多重耐药感染的广谱抗生素。由于其药代动力学特性,通过延长输注(EI)、持续输注或间歇输注给药策略,使血清浓度维持在最低抑菌浓度(MIC)以上的特定时间,可优化美罗培南的活性。关于这些给药策略的优越性,现有文献存在差异。本研究的主要目的是确定静脉推注(IVP)和美罗培南EI给药在临床稳定时间上的差异。我们对100例在重症监护病房(ICU)住院期间接受IVP(n = 50)或EI(n = 50)美罗培南治疗的重症患者进行了一项回顾性试点队列研究。IVP组和EI组在临床稳定的总体达成率上没有统计学显著差异(48%对44%,P = 0.17)。然而,EI组达到临床稳定的中位时间较短(20.4小时对66.2小时,P = 0.01)。EI给药与较短的住院时间(13天对17天;P = 0.05)和ICU住院时间(6天对9天;P = 0.02)相关。虽然我们在临床稳定的总体时间上未发现统计学显著差异,但这项试点研究的结果表明,EI给药可能比IVP产生更快的临床缓解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a155/11429397/b5a5f95cf456/antibiotics-13-00835-g001.jpg

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