摘要
目的监测老年患者使用头孢哌酮舒巴坦后的血药浓度,结合患者病理生理状况,评价其安全性、合理性、有效性,制定个体化给药方案。方法对2017年使用头孢哌酮舒巴坦并进行血药浓度监测的42例老年患者的疾病情况、用药天数、合并用药、病原学检查、不良反应及药物疗效等指标进行统计分析。结果 42例患者共监测血药浓度43例次,采用头孢哌酮舒巴坦2.0 g,每12小时1次方案时,肾功能正常老年患者头孢哌酮血药浓度为(93.62±5.67)μg/ml,轻度肾功能减退老年患者头孢哌酮血药浓度为(109.76±28.61)μg/ml,中度肾功能减退老年患者头孢哌酮血药浓度为(105.13±30.49)μg/ml;中度肾功能减退患者以2.0 g,每8小时1次方案使用头孢哌酮血药浓度为(164.80±40.92)μg/ml。患者头孢哌酮血药浓度高于220μg/ml时应警惕出现头孢类抗生素脑病的风险。结论老年患者使用头孢哌酮舒巴坦治疗,血药浓度随着肾功能状况及用药方案不同,个体差异大,通过血药浓度监测可减少不良反应,提高治疗效果。
Objective To evaluate the safety,rationality and effectiveness according to the blood concentration of cefoperazone sulbacetam sodium in elderly patients,and combined with the pathological and physiological conditions of the patients,and then formulate individualized drug administration plan.Methods The disease status,days of medication,combined medication,etiological examination,adverse reactions and drug efficacy of 42 elderly patients with cefoperazone sulbacetam sodium and blood drug concentration monitoring in 2017 were statistically analyzed.Results A total of 42 patients were monitored for 43 times,when treated with a drug regimen of 2.0 g,once every 12 hours,the blood concentrations of cefoperazone in the patients with normal renal function,the blood concentration of cefoperazone in elderly patients with normal renal function was(93.62 ± 5.67) μg/ml,the blood concentration of cefoperazone in elderly patients with mild renal impairment was(109.76 ± 28.61) μg/ml,and the blood concentration of cefoperazone in elderly patients with moderate renal impairment was(105.13 ± 30.49) μg/ml;The blood concentration of cefoperazone was(164.80 ± 40.92) μg/ml in patients with moderate renal dysfunction at 2.0 g,once every 8 hours.Patients should be aware of the risk of cephalosporin encephalopathy when the blood concentration of cefoperazone was higher than 220 μg/ml.Conclusion The blood drug concentration varies greatly with the renal function status and drug regimen in elderly patients that treated with cefoperazone sulbactam,monitoring blood drug concentration can reduce adverse reactions and improve the treatment effect.
作者
曹毅
彭国茳
王时云
CAO Yi;PENG Guojiang;WANG Shiyun(Affiliated Hospital of Xiangnan University,Hunan Province,Chenzhou,423000,China;不详)
出处
《临床合理用药杂志》
2020年第25期4-7,共4页
Chinese Journal of Clinical Rational Drug Use
基金
湖南省卫生计生委科研计划项目(No:B2016154)
湘南学院校级课题(No:2015XB16,2016XJ58)。
关键词
头孢哌酮舒巴坦
老年患者
血药浓度监测
个体化给药
Cefoperazone and sulbactam
Elderly patients
Blood drug concentration monitoring
Individualized drug administration
