临床误诊误治2018，Vol.31Issue(6)：76-80,5.DOI:10.3969/j.issn.1002-3429.2018.06.024
药物监测美罗培南对脓毒症临床治疗效果的影响
Effects of Therapeutic Drug Monitoring of Meropenem on Clinical Efficacy of Sepsis Treatment
摘要
Abstract
Objective To investigate the effects of therapeutic drug monitoring of Meropenem on clinical ef-ficacy of sepsis treatment. Methods A total of 113 patients admitted and treated in our hospital were included in this study, who were divided into observation group (n=57) and control group(n=56) according to application of TDM of Meropenem. The inflammatory markers and biochemical indexes of the laboratory test as well as the severity of the disease were compared between the two groups at 1 and 7 days. In addition, the occurrence of adverse reac-tions and the 28-day mortality were recorded. Results The levels of C-reactive protein ( CRP ) , procalcitonin, WBC, neutrophilic granulocyte percentage, sequential organ failure assessment ( SOFA) , acute physiology and chro-nic health evaluation ( APACHE) scoring systemⅡof both groups as well as the levels of AST and bilirubin in obser-vation group were decreased at 7 days, as compared with those at 1 day, and the difference was statistically signifi-cant (P<0.05). In observation group, the levels of CRP, SOFA score and APACHEⅡscore were decreased at 7 days, compared with those in control group, suggesting significant differences (P<0.05). Specifically, APACHEⅡwas significantly lower at 7 days than at 1 day, showing significant differences. There was no significant difference in adverse effects between the two groups ( P=0.548 ) . The 28-day mortality rates in the observation group and the control group were 7. 0％ and 19. 6％, respectively. The difference was statistically significant (P=0.048). Con-clusion Routine doses of Meropenem are often inadequate to achieve pharmacokinetic/pharmacodynamics goals in the treatment of sepsis, however, increased dose may lead to an increase in toxicity and side effects. Therefore, an individualized dosing regimen should be developed based on TDM.关键词
脓毒症/美罗培南/治疗/药物监测Key words
Sepsis/Meropenem/Therapeutic/Drug monitoring分类
医药卫生引用本文复制引用
郁彬,费爱华..药物监测美罗培南对脓毒症临床治疗效果的影响[J].临床误诊误治,2018,31(6):76-80,5.基金项目
上海市科学技术委员会基金项目(17d22307600) （17d22307600）
上海交通大学医学院附属新华医院院基金(XHEC-C-2015-047-2) （XHEC-C-2015-047-2）
