喜炎平注射液联合比阿培南治疗重症肺炎的临床研究

目的 探讨喜炎平注射液联合比阿培南治疗重症肺炎的临床效果。方法 选取2019年3月—2022年3月天津市第五中心医院收治的118例重症肺炎患者,按随机数字表法将所有患者分成对照组和治疗组,每组各59例。对照组静脉滴注注射用比阿培南,每次将0.3 g溶于100 mL生理盐水中,滴注30～60 min,2次/d。治疗组在对照组基础上静脉滴注喜炎平注射液,每次将500 mg加入250 mL生理盐水中,1次/d。两组连续治疗14 d。观察两组的临床疗效和典型表现（发热、咳嗽、胸闷痛、肺部啰音、白细胞异常）消失时间。比较治疗前后两组临床肺部感染评分（CPIS）、急性生理功能和慢性健康状况评分系统Ⅱ（APACHEⅡ）评分及血清C反应蛋白（CRP）、降钙素原（PCT）、可溶性细胞间黏附分子-1(sICAM-1)、白细胞介素（IL）-17、基质金属蛋白酶-9(MMP-9)水平。结果 治疗后,治疗组总有效率为93.2%,显著高于对照组的81.4%(P<0.05)。治疗后,治疗组发热、咳嗽、胸闷痛、肺部啰音、白细胞异常的消失时间均较对照组显著缩短（P<0.05）。治疗后,两组CPIS评分和AP...     

比阿培南治疗肝衰竭并发细菌感染疗效观察

目的观察比阿培南治疗肝衰竭并发细菌感染的临床疗效。方法30例肝衰竭并发细菌感染患者随机分成两组,分别给予比阿培南（观察组）、头孢哌酮／他唑巴坦钠（对照组）治疗,治疗1周后比较两组疗效。结果观察组有效率86．67％、治愈率73．33％,优于对照组（53．33％、33．33％,均P〈0．05）。结论比阿培南治疗肝衰竭并发细菌感染疗效确切,不良反应轻微。     

比阿培南在人肝微粒体、人肾S9和体外人血浆中的稳定性及其代谢产物鉴定

目的:考察比阿培南在人肝微粒体、人肾S9和体外人空白血浆中的代谢稳定性,并推测代谢产物的结构及可能的代谢途径.方法:采用高效液相色谱-串联质谱联用仪(HPLC-MS/MS)检测比阿培南分别与人肝微粒体、人肾S9和人空白血浆孵育后孵育液中剩余的比阿培南含量,比较代谢稳定性.此外,利用快速液相色谱-离子阱-飞行时间质谱联用...     

采用“药品利用评估”标准 促进比阿培南的合理应用

采用回顾性调查方法,用2013年底修改后的比阿培南的DUE标准,对我院2014年1月~6月共175例比阿培南的使用情况进行分析评价。结果表明比阿培南DUE标准的修订,可以更好地促进比阿培南的临床合理应用。     

Evaluating biapenem dosage regimens in intensive care unit patients with Pseudomonas aeruginosa infections: a pharmacokinetic/pharmacodynamic analysis using Monte Carlo simulation

This study was conducted to identify optimal dosage regimens and estimate pharmacokinetic/pharmacodynamic (PK/PD) characteristics of short-infusion (SI) versus extended-infusion (EI) biapenem against Pseudomonas aeruginosa infections in Chinese intensive care unit (ICU) patients. A total of 85 strains of P. aeruginosa were collected, and the minimum inhibitory concentration (MIC) of biapenem was measured by the serial two-fold agar dilution method. We designed four frequently used clinical regimens: biapenem 300?mg I.V. q12h, q8h, and q6h, and 600?mg q12h. The Monte Carlo Simulation (MCS) was performed using previously published pharmacokinetic data to calculate the probability of target attainment (PTA) and the cumulative fraction of response (CFR) of these regimens as an SI (0.5?h) and an EI (1?h, 2?h, 3?h, and 4?h).For a target of 40%fT_>MIC (serum drug concentration remains above the MIC for a dosing period), none of the regimens achieved any CFRs>90% for P. aeruginosa, multidrug–resistant P. aeruginosa (MDR-PA) and even non–MDR-PA. The traditional biapenem SI regimens most commonly seen in clinical practice were insufficient in treating both MDR and non-MDR P. aeruginosa in ICU patients. However, biapenem 600?mg q12h over 2–4?h EI regimens could achieve CFR>90% with 20%fT_>MIC. Clinical trials should aim to validate the potentially greater PK/PD index with higher, more frequent doses and longer extended infusions.     

比阿培南致继发性血小板增多症1例报道并碳青霉烯抗生素不良反应文献复习

【】 目的：提高对碳青霉烯抗生素不良反应的认识。方法：报道1例外伤并感染患者使用比阿培南而导致继发性血小板增多症,并且复习碳青霉烯类抗生素不良反应相关文献。结果：停用比阿培南一周后,该患者血小板逐渐降至正常。结论：碳青霉烯类抗生素有可能引起血小板增多症,临床需关注由此可能导致的血管栓塞等不良反应。     

比阿培南对鲍曼不动杆菌的抗菌活性评价

目的：评价比阿培南对鲍曼不动杆菌的体外抗菌活性。方法：应用琼脂稀释法测定比阿培南、美罗培南、亚胺培南、头孢他啶对临床分离出的30株鲍曼不动杆菌的最低抑菌浓度（MIC）,并计算MIC50和MIC90。结果：比阿培南、美罗培南、亚胺培南、头孢他啶的MIC50分别为2、4、2、128μg/ml,MIC90分别为16、32、32μg/ml、512μg/ml,耐药率分别为20.0%、30.0%、33.3%、70.0%。结论：比阿培南与其他3种药物比较对鲍曼不动杆菌有更强的体外抗菌活性。     

HPLC法测定人血浆中比阿培南的浓度及其药动学研究

目的：建立人血浆中比阿培南的高效液相色谱检测方法。方法：色谱柱为Agilent ZORBAX Bonus-RP（4.6 mm×250 mm,5μm）;流动相为甲醇和0.03%醋酸水溶液,采用梯度洗脱法;流速为1.00 ml/min;检测波长为300 nm,血浆样品处理选用5-羟基吲哚乙酸为内标,采用硫酸锌沉淀蛋白。结果：比阿培南在0.2～50.0μg/ml范围内线性良好,HPLC测定定量下限为0.2μg/ml,比阿培南和内标在血浆的保留时间分别为3.9 min和9.7 min,出峰迅速。比阿培南浓度分别为0.5、5.0和40.0μg/ml,血浆样本回收率分别为101.8%、100.8%、100.4%;精密度试验日内和日间RSD均小于15%,稳定性试验结果表明血浆样品在样品处理过程中较稳定（RSD〈15%）。结论：本方法灵敏度高,操作简便,快速,重复性好,适用于比阿培南血浆浓度的测定。     

Efficacy and safety of biapenem in treatment of infectious disease: a meta-analysis of randomized controlled trials

Background: Biapenem is a parenteral carbapenem antibiotic that has powerful antibacterial activity. The aim of this study is to evaluate the efficacy and safety of biapenem for the treatment of infection diseases.

Methods: We performed a meta-analysis of published randomized-controlled trials (RCTs) identified in Embase, PubMed, and Cochrane library that compared the efficacy and safety of biapenem with other antibiotic regimes for the treatment of patients with infections.

Results: Eight RCTs were included in the meta-analysis, involving totally 1685 patients with lower respiratory tract infections (LRTIs), complicated urinary tract infections (cUTIs), and complicated intra-abdominal infections (cIAIs). There was no difference found between the patients with LRTIs, cUTIs, or cIAIs treated with biapenem and comparators, regarding treatment success and adverse events.

Conclusion: This meta-analysis provides evidence that biapenem can be used as effectively and safely as imipenem–cilstatin or meropenem, for the treatment of patients with LRTIs, cUTIs, and cIAIs. It may be a considerable option for the treatment of these infections.     

注射用比阿培南与5种输液配伍稳定性考察

目的建立HPLC法测定注射用比阿培南的含量,并考察其与0.9%氯化钠、5%葡萄糖、10%葡萄糖、葡萄糖氯化钠、复方氯化钠注射液配伍的稳定性。方法采用色谱柱Symmetry C18（4.6×150mm,5μm）、流动相为醋酸盐缓冲液∶乙腈（100∶3,v/v）、检测波长294nm;在25℃、室内自然光照射下观察配伍液的外观变化,同时监测配伍液pH值及比阿培南含量的变化。结果比阿培南线性范围0.01~1.0mg.mL-1,r=0.9998（n=8）;平均回收率99.57%,RSD 1.30%,最低定量限58ng.mL-1（S/N≥10）。在0.9%氯化钠注射液、5%葡萄糖注射液中10h,葡萄糖氯化钠注射液中8h,10%葡萄糖注射液中5h,比阿培南的含量变化均〈5%;在复方氯化钠注射液中,3h时比阿培南的含量即小于95%。5种配伍液pH值均略降低,但24h内皆未超出药典规定范围。葡萄糖氯化钠配伍液6h起,10%葡萄糖配伍液10h起,颜色开始逐渐变黄加深。结论在25°C室内自然光照射下,比阿培南可与除复方氯化钠以外的本文其他4种输液配伍使用,但须注意稳定时间有所差别。本文建立的HPLC法适用于比阿培南含量测定。