碳青霉烯类抗生素与丙戊酸相互作用的特点、机制及临床意义

摘要

目的：简述碳青霉烯类抗生素与丙戊酸相互作用的特点与机制，为临床合理用药提供参考。方法检索国内外医药数据库，下载有关碳青霉烯类抗生素与丙戊酸相互作用的文献，进行文献综述。结果碳青霉烯类抗生素可大幅度迅速降低丙戊酸的血药浓度，因而导致患者癫痫再发作或发作频率增加。美罗培南的报道最多，影响最为严重。相互作用的主要机制是抑制丙戊酸葡萄糖醛酸结合物的水解。结论碳青霉烯类抗生素与丙戊酸不宜合用。%Objective To summarize characteristics and mechanism of interaction between car-bapenem antibiotics and valproic acid, provide the reference for clinical rational drug use. Meth-ods Domestic and international pharmaceutical database was retrieved, to conduct a literature review. Results Carbapenem antibiotics can be greatly decreased serum concentration of valproic acid, resulting epileptic seizured again or seizure frequency increased. Meropenem was reported the most, and affected severely. The main mechanism of interaction was inhibited hydrolysis of valproic acid glucuronide conjugates. Conclusion Carbapenem antibiotic and valproate wasn’t an appropriate combination.