电邮这篇文章 
发表评论 剖宫产术后子宫内膜炎的抗菌治疗：给药方案的优化
- 作者: Korobkov N.1, Bakulina N.1, Repina M.1
-
隶属关系:
- North-Western State Medical University named after I.I. Mechnikov
- 期: 卷 12, 编号 4 (2020)
- 页面: 67-72
- 栏目: Original research
- URL: https://journals.rcsi.science/vszgmu/article/view/50864
- DOI: https://doi.org/10.17816/mechnikov50864
- ID: 50864
如何引用文章
开放存取
##reader.subscriptionAccessGranted##
订阅存取
详细
本研究的目的是研究β-内酰胺类抗生素在剖宫产术后子宫内膜炎发生中的药代动力学，以选择最佳的给药方案。
方法。一项前瞻性、随机、单中心研究纳入了52名剖宫产术后子宫内膜炎的妇女，分为四组。第一组（n=17）注射一剂头孢曲松2.0 g，每日1次（n=10），在长期围术期输注模式（n=7）；第二组患者（n=10）注射一剂头孢吡肟2.0 g，每日2次（n=5），在长期输注模式（n=5）；第三组患者（n=14）注射一剂阿莫西林/克拉维酸1.0 g（Amoxiclav® 1000 mg + 200 mg），每日3次（n=7），在长期输注模式（n=7）；第四组患者（n=11）注射一剂氨苄西林/舒巴坦1.0 g（Ampisid® 1000 mg + 500 mg），每日4次（n=6），在长期输注模式（n=5）。采用高效液相色谱法比较四组子宫腔内抗菌药物的浓度。
主要结果。各治疗组的有效杀菌浓度（C>4×MIC）均未在整个剂量间期保持。所研究的抗生素方案的临床疗效和安全性相似。然而，延长输注头孢吡肟和氨青霉素的血性恶露浓度明显升高。
结果。长期静脉输注头孢吡肟、头孢曲松、阿莫西林/克拉维酸、氨苄西林/舒巴坦治疗剖宫产术后子宫内膜炎，与传统的单次给药剂量相比，可改善这些β-内酰胺类药物在宫腔内的药代动力学/药效的特性。
作者简介
Nikolay Korobkov
North-Western State Medical University named after I.I. Mechnikov
编辑信件的主要联系方式.
Email: nikolai_korobkov@mail.ru
ORCID iD: 0000-0001-7279-2535
доцент кафедры акушерства и гинекологии
俄罗斯联邦, Saint PetersburgNatal'ya Bakulina
North-Western State Medical University named after I.I. Mechnikov
Email: nv_bakulina@mail.ru
д.м.н., профессор, зав. кафедрой внутренних болезней, клинической фармакологии и нефрологии
俄罗斯联邦, Saint PetersburgM. Repina
North-Western State Medical University named after I.I. Mechnikov
Email: info@eco-vector.com
д.м.н., профессор
俄罗斯联邦, Saint Petersburg参考
- Antimicrobial resistance. WHO. 2019. Available from: https://www.who.int/activities/optimizing-selection-and-use-of-antimicrobial-medicines.
- Avent, ML, Rogers BA. Optimising antimicrobial therapy through the use of Bayesian dosing programs. Int J Clin Pharm. 2019;41(5):1121–1130. https://doi.org/10.1007/s11096-019-00886-4.
- Brinkmann A, Rohr AC, Koberer A, et al. Adequate anti-infective treatment: Importance of individual dosing and application. Anaesthesist. 2018;67(6):461–476. (In German). https://doi.org/10.1007/s00101-018-0443-4.
- Maarbjerg SF, Thorsted A, Kristoffersson A, et al. Piperacillin pharmacokinetics and target attainment in children with cancer and fever: Can we optimize our dosing strategy? Pediatric blood & cancer. 2019;66(6):e27654. https://doi.org/10.1002/pbc.27654.
- Marsot A. Pharmacokinetic variability in pediatrics and intensive care: Toward a personalized dosing approach. J Pharm Pharm Sci. 2018;21(1):354–362. https://doi.org/10.18433/jpps30082.
- Септические осложнения в акушерстве: клинические рекомендации (протокол лечения) / Л.В. Адамян, Н.В. Артымук, Т.Е. Белокриницкая и др. – Москва, 2017. – 45 с. [Septicheskie oslozhneniya v хakusherstve: klinicheskie rekomendatsii (protokol lecheniya) / L.V. Adamyan, N.V. Artymuk, T.E. Belokrinitskaya, et al. Moskow; 2017. 45 p. (In Russ.)]
- Luo J, Liao J, Cai R, et al. Prolonged versus intermittent infusion of antibiotics in acute and severe infections: А meta-analysis. Arch Iran Med. 2019;22(10):612–626.
- Shiu J, Wang E, Tejani AM, Wasdell M. Continuous versus intermittent infusions of antibiotics for the treatment of severe acute infections. Cochrane Database Syst Rev. 2013;28(3):CD008481. https://doi.org/10.1002/ 14651858.CD008481.pub2.
- Клинические рекомендации. Определение чувствительности микроорганизмов к антимикробным препаратам / Межрегиональная ассоциация по клинической микробиологии и антимикробной химиотерапии. 2014. C. 154. Режим доступа: http://metodichka.x-pdf.ru/15himiya/148495-1-metodicheskie-rekomendacii-utverzhdeni-rasshirennoe-soveschanie-mezhregionalnoy-associacii-klinicheskoy-mikrobiologii-anti.php. [Klinicheskie rekomendatsii. Opredelenie chuvstvitel’nosti mikroorganizmov k antimikrobnym preparatam. The Interregional Association for Clinical Microbiology and Antimicrobial Chemotherapy. 2014. P. 154. Available from: http://metodichka.x-pdf.ru/15himiya/148495-1-metodicheskie-rekomendacii-utverzhdeni-rasshirennoe-soveschanie-mezhregionalnoy-associacii-klinicheskoy-mikrobiologii-anti.php (In Russ.)]
- Craig WA, Ebert SC. Killing and regrowth of bacteria in vitro: A review. Scand J Infect Dis Suppl. 1990;(74):63–70.
- Craig WA. Pharmacokinetic/pharmacodynamic parameters: rationale for antibacterial dosing of mice and men. Clin Infect Dis. 1998;26(1):1–10. https://doi.org/10.1086/516284.
补充文件
