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依据抗菌药物的药动学/药效学原理,本文建立蒙特卡洛模拟模型,优化比较亚胺培南/西司他丁(剂量以亚胺培南计)和左氧氟沙星抗感染治疗的给药方案。模拟试验表明,亚胺培南0.5 g/8 h静脉滴注对鲍曼不动杆菌、肺炎克雷伯菌感染的疗效较好,累积反应分数(CFR)分别为97.28%和99.71%;对铜绿假单孢菌,低剂量的CFR不够理想,增大剂量可以提高CFR,但低于90%,提示经验治疗时须考虑联合用药。左氧氟沙星静脉滴注0.2g/d对卡他莫拉菌有效,CFR为100%;对肺炎克雷伯菌,0.2g/d、0.3 g/d、0.5g/d和0.75 g/d各治疗方案的CFRs相近,约为55%,增加剂量未能增强效果;对肺炎链球菌,0.5g/d的日剂量CFR达100%,可具有治疗效果。蒙特卡洛模拟可预测和优化抗菌药的用药设计,帮助临床选择合适的抗感染治疗方案。
Based on the pharmacokinetic / pharmacodynamic principles of antibacterials, a Monte Carlo simulation model was established to optimize the dosing regimen of imipenem / cilastatin (imipenem at dose) and anti-infective therapy with levofloxacin . The simulation test showed that imipenem 0.5 g / 8 h intravenous infusion of Acinetobacter baumannii, Klebsiella pneumoniae infection better curative effect, the cumulative reaction fraction (CFR) were 97.28% and 99.71% Pseudomonas, low-dose CFR less than ideal, increasing the dose can increase CFR, but less than 90%, suggesting that empirical treatment should be considered when combined. Levofloxacin 0.2g / d intravenous infusion of Moraxella catarrhal effective, CFR of 100%; for Klebsiella pneumoniae, 0.2g / d, 0.3g / d, 0.5g / d and 0.75g / d of the treatment programs Of the CFRs is similar, about 55%, increasing the dose failed to enhance the effect; Streptococcus pneumoniae, 0.5g / d daily dose CFR up to 100%, can have a therapeutic effect. Monte Carlo simulation predicts and optimizes the design of antibacterial drugs to help clinically select the appropriate anti-infective treatment.