Nyhlén A, Ljungberg B, Nilsson-Ehle I
Department of Infectious Diseases, University Hospital of Lund, Sweden.
Eur J Clin Microbiol Infect Dis. 1997 Nov;16(11):797-802. doi: 10.1007/BF01700408.
To determine the impact of neutropenia on the pharmacokinetics of meropenem, 14 patients with fever and neutropenia were given 1 g of meropenem i.v. every 8 h as an infusion over 30 min. The volume of distribution (16.2 l/1.73 m2) and the nonrenal clearance [75 ml/(min x 1.73 m2)] in this group were significantly increased compared to healthy subjects studied previously with identical techniques. The kinetic study was repeated when the patients had a normal temperature and a raised neutrophil count; most kinetic variables did not differ from the findings on the first day of treatment. The pharmacokinetic profile of meropenem in febrile neutropenic patients differs from earlier findings in healthy subjects. Considering these data and known minimum inhibitory concentration values for common pathogens, meropenem administered every 6 to 8 h seems an appropriate regimen in patients with febrile neutropenia. The shorter time interval may be used for treatment of Pseudomonas infection.
为确定中性粒细胞减少对美罗培南药代动力学的影响，14例发热伴中性粒细胞减少的患者接受了静脉注射1g美罗培南的治疗，每8小时一次，输注时间为30分钟。与先前采用相同技术研究的健康受试者相比，该组患者的分布容积（16.2 l/1.73 m²）和非肾清除率[75 ml/（min×1.73 m²）]显著增加。当患者体温正常且中性粒细胞计数升高时，重复进行动力学研究；大多数动力学变量与治疗第一天的结果无差异。发热伴中性粒细胞减少患者中美罗培南的药代动力学特征与健康受试者早期的研究结果不同。考虑到这些数据以及常见病原体已知的最低抑菌浓度值，每6至8小时给予美罗培南似乎是发热伴中性粒细胞减少患者的合适治疗方案。较短的时间间隔可用于治疗铜绿假单胞菌感染。
