目的：为临床合理应用哌拉西林钠舒巴坦钠抗铜绿假单胞菌感染提供参考。方法：选择我院2013年7月－2014年6月经病原学检测确诊为铜绿假单胞菌感染且对哌拉西林钠舒巴坦钠敏感的肝、肾功能正常的住院患者105例，统计给药方案，以一室药动学模型为基础，设定哌拉西林钠舒巴坦钠对铜绿假单胞菌的最低抑菌浓度（MIC）为1 mg/L，血药浓度＞MIC的持续时间（T＞MIC）占给药间隔时间的百分比的达标值为45％，采用单剂量和多剂量重复多次静脉滴注给药的药动学公式计算T＞MIC，分析其达标情况；然后将原方案的给药间隔时间适当延长，同法考察T＞MIC占给药间隔时间的百分比的达标情况。结果：105例患者中有47例采用每隔8 h给予3.0 g的给药方案，58例采用每隔12 h给予3.0 g的给药方案；针对铜绿假单胞菌，两种给药方案的T＞MIC占给药间隔时间的百分比，依据单剂量静脉滴注给药药动学公式计算结果分别为99.93％和73.13％，依据多剂量重复多次静脉滴注给药药动学公式计算结果分别为99.98％和68.08％；给药间隔时间延长至16 h后，其结果分别为54.84％和51.06％，仍均达到设定的达标值。结论：抗菌药物药动学/药效学（PK/PD）预测参数的定量分析，可用于评价与优化临床用药方案，指导实践。%OBJECTIVE:To provide reference for clinical rational use of piperacillin sulbactam for the anti-infection of Pseudo-monas aeruginosa. METHODS:105 inpatients with normal liver and kidney functions that the pathogen was diagnosed as P. aerugi-nosa and susceptible to PIP/SBT from Jul. 2013 to Jun. 2014 were chose,dosing regimens were collected,the minimum inhibitory concentration (MIC) of piperacillin sulbactam for P. aeruginosa was 1 mg/L based on a one compartment pharmacokinetic mode, the standard value of the percentage of the duration of plasma concentration more than MIC(T>MIC)to dosing interval time was 45%,T>MIC was calculated with pharmacokinetic formula of both single dose and multiple dose repeated intravenous administra-tion to analyze the situation of reaching the standard of T>MIC;and the dosing interval time of the original scheme was prolonged appropriately to investigate the situation of reaching the standard of the percentage of (T>MIC) to dosing interval time. RE-SULTS:47 patients’dosing regimens were given 3.0 g PIP/SBT once every 8 hours,and the others were given 3.0 g PIP/SBT once every 12 hours;for P. aeruginosa,the percentages of T>MIC to dosing interval time were respectively 99.93% and 73.13% with pharmacokinetic formula of single dose intravenous administration,and 99.98%and 68.08%with pharmacokinetic formula of multi-ple dose repeated intravenous administration;and the percentages of the interval time prolonged to 16 h were respectively 54.84%and 51.06%,both reached the standard value. CONCLUSIONS:Quantitative analysis of PK/PD prediction parameters can be used to evaluate and optimize the clinical dosing regimens and guide the clinical practice.
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