摘要
目的基于临床前药效学(PD)和临床药动学(PK)的实验数据资料,进行给药方案的Monte carlo模拟,确定氟罗沙星的最佳给药剂量,从而优化其临床给药方案。方法结合氟罗沙星的药敏实验及临床药动学等PK/PD相关实验数据资料,以口服氟罗沙星片200、300和400mg每日1次(Qd),3种给药方案,治疗近几年来河南地区常见的临床分离致病菌。进行Monte carlo模拟,将获得的累积反应分数(CFR)做给药方案的比较。结果以CFR>90%的给药方案为最佳给药方案,对于大肠埃希菌和淋球菌引起的感染,仅需口服200mg(Qd);对硝酸盐阴性杆菌、肠杆菌属和哈夫尼亚菌属引起的感染,口服300mg(Qd);对于表皮葡萄球菌、铜绿假单胞菌、志贺菌属、肺炎克雷伯菌、柠檬酸杆菌属、普通变形菌、肺炎链球菌、沙门菌属和金黄色葡萄球菌(MSSA)引起的感染,口服400mg(Qd)可获得预期满意的临床疗效并能有效预防细菌耐药性产生。结论临床中针对不同耐药菌感染的给药方案治疗所需要的给药剂量存在着明显差异,使用氟罗沙星要根据致病菌从而选择合适的剂量。
Objective To design clinical optimal dosage regimen offleroxacin by Monte carlo simulation using the data of preclinical pharmacodynamics（PD） and the pharmacokinetics（PK）. Methods Fleroxacin susceptibility combined experimental and clinical pharmacokinetic experiments such as PK/PD-related data. Three kinds of dosing regimens with oral fleroxacin 200, 300 and 400mg tablets once a day（Qd） were used to treat Henan common clinical isolates of pathogens in recent years. Cumulative response scores （CFR） abtained by Monte carlo simulation, would be used as the comparison regimen. Resluts With the dosage of CFR〉90% as the optimal dosage regimen, the lowest dosage for treating common infection caused by Escherichia coli and Neisseria gonorrhoeae was 200mg a day, by Nitrate negative bacillus, Enterobacter and Hafnia was 300mg a day, by Staphylococcus epidermidis, Pseudomonas aeruginosa, Shigella spp., Klebsiella pneumoniae, Citrobacter, Proteus vulgaris, Streptococcus pneumoniae, Salmonella and Staphylococcus aureus was 400mg a day. Conclusion In clinics, dose required in different therapeutic schemes for drug resistance bacteria infection was difference. Suitable dose for fleroxacin should be chosen.
出处
《中国抗生素杂志》
CAS
CSCD
北大核心
2014年第6期470-474,共5页
Chinese Journal of Antibiotics
基金
河南省科技攻关项目(092102310275)
