帕尼培南-倍他米隆体外抗菌活性及其对肺部感染病人的疗效观察

目的 :了解帕尼培南 倍他米隆对临床常见致病菌的体外抗菌活性及治疗肺部感染的有效性及安全性。方法 :采用琼脂二倍稀释法测定帕尼培南 倍他米隆对 2 4 7株临床分离菌的MIC ,检测其对部分菌株的最低杀菌浓度 ;2 0例肺部感染病人使用帕尼培南 倍他米隆 5 0 0 /5 0 0mg ,q 12h ,iv ,gtt ,疗程3～ 7d。结果 :帕尼培南 倍他米隆与帕尼培南的体外抗菌活性基本一致 ,MIC50 ≤ 0 .0 0 75mg·L- 1,MIC90 为 0 .0 0 75～ 2mg·L- 1;对流感嗜血杆菌的MIC范围为 <0 .0 0 75～ 0 .12 5mg·L- 1;对阴沟肠杆菌、变形肠杆菌、铜绿假单孢菌的MIC50 和MIC90 分别为 0 .12 5和 0 .5 ,2和 4 ,4和 16mg·L- 1;帕尼培南 倍他米隆对金黄色葡萄球菌、表皮葡萄球菌、铜绿假单孢菌、肺炎克雷伯菌、大肠埃希菌、阴沟肠杆菌、变形肠杆菌及微球菌的最低杀菌浓度分别是其MIC的 1～ 8倍。致病菌阴转率为 77.8% ,治疗有效率为 75 % ,未出现明显不良反应。结论 :帕尼培南 倍他米隆对临床常见致病菌的体外抗菌活性强 ;对肺部感染有较好疗效 ,安全性好     

帕尼培南／倍他米隆对下呼吸道感染患者的疗效观察

目的 :评价帕尼培南 倍他米隆治疗下呼吸道感染的有效性及安全性。方法 :38例下呼吸道感染患者使用帕尼培南 倍他米隆 5 0 0 5 0 0mg ,每 12h 1次 ,静脉滴注 ,疗程 3d～ 7d ,观察其细菌培养结果及疗效。结果 :致病菌阴转率为 87 9% ,治疗有效率为81 6 % ,未出现明显不良反应。结论 :帕尼培南 倍他米隆对临床常见致病菌的抗菌活性强 ,对下呼吸道感染有较好疗效 ,安全性好。     

帕尼培南-倍他米隆对重症下呼吸道感染的临床评价

目的　评价帕尼培南 倍他米隆治疗危重病人下呼吸道感染的临床疗效。方法　 14 0例下呼吸道感染的危重病人 ,随机分为治疗组 70例 ,对照组 70例。分别应用帕尼培南 倍他米隆和亚胺培南 西司他丁 ,剂量均为 2 0 g/d ,静脉滴注给药 ,疗程 7～ 14d。 结果　帕尼培南 倍他米隆和亚胺培南 西司他丁的临床有效率分别为 81 4%和 82 9% ,细菌清除率分别为 75%和 76 1%。均无明显不良反应。结论　帕尼培南 倍他米隆可作为重症下呼吸道感染有效和安全的抗生素     

帕尼培南/倍他米隆的体外抗菌活性研究

为评价帕尼培南的体外抗菌作用，采用琼脂二倍稀释法测定帕尼培南／倍他米隆对247例临床分离菌的最低抑菌浓度（MIC），并与其它5种抗菌药物进行比较，结果表明，帕尼培与亚胺培南体外抗菌作用相仿，但帕尼培南对流感嗜血杆菌，金黄色葡萄球菌包括耐甲氧西林金葡萄球菌（MRSA）和大肠埃希氏菌体外胺培南对肺炎克雷伯氏菌、大肠埃希氏菌等革兰氏阴性菌作用略逊于美罗培南，帕尼培南体外抗菌 于头孢他啶，头孢哌酮／舒巴坦，苯唑西林等其它受试药物。帕尼培南的体外抗菌活性受接种菌量，培养基PH值和血清浓度影响。结果表明，帕尼培南是治疗多重耐药菌所致院内感染和严重需氧菌与厌氧菌混合感染的适用药物。     

帕尼培南/倍他米隆治疗小儿难治性化脓性脑膜炎的疗效与安全性

目的:评价帕尼培南/倍他米隆治疗小儿难治性化脓性脑膜炎的临床疗效及安全性。方法:收集2011年7月至2017年7月我院儿科收治的难治性化脓性脑膜炎患儿63例,分成帕尼培南/倍他米隆组与美罗培南组,观察两组患儿的临床疗效和不良反应。结果:美罗培南组30例,有效率93.33%,细菌培养阳性率为53.33%,细菌清除率81.25%;帕尼培南/倍他米隆组33例,总有效率90.91%,细菌培养阳性率为57.58%,细菌清除率84.21%,两组患儿有效率、细菌培养阳性率、细菌清除率比较差异无统计学意义(P均>0.05)。治疗后美罗培南组出现口腔白色念珠菌感染4例,帕尼培南/倍他米隆组出现3例,差异无统计学意义(P>0.05)。所有患儿均未出现明显肝肾功能损伤,无过敏反应。结论:帕尼培南/倍他米隆治疗小儿难治性化脓性脑膜炎安全且疗效确切。     

注射用帕尼培南/倍他米隆的人体药动学研究

目的:考察注射用帕尼培南/倍他米隆在呼吸系统感染患者体内的药动学。方法:15名受试者静脉滴注注射用帕尼培南/倍他米隆(0.5g/0.5g)后,采用高效液相色谱(HPLC)法测定帕尼培南、倍他米隆的血药浓度,计算药动学参数。结果:帕尼培南、倍他米隆的平均药动学参数分别为t1/2α(0.30±0.20)、(0.10±0.05)h,t1/2β(1.4±0.3)、(0.61±0.20)h,AUC0～6.5h(42±8)、(20±5)mg·h·L-1,CLs(10.8±1.5)、(29.7±8.5)L·h-1,Vd(10.2±0.9)、(8.8±1.5)L。结论:帕尼培南/倍他米隆在呼吸系统感染患者体内的药动学及药效学评价可以指导临床应用。     

帕尼培南/倍他米隆与亚胺培南/西司他丁治疗细菌感染疗效与安全性的Meta分析

目的评价碳青霉烯类抗菌药物帕尼培南/倍他米隆与亚胺培南/西司他丁在细菌感染治疗中的疗效和安全性。方法利用计算机检索Pub Med、Medline、Cochrane library、中国期刊全文数据库、万方数据库和维普数据库等。2名研究员背对背提取资料,并对其方法学质量进行评价。纳入比较帕尼培南/倍他米隆与亚胺培南/西司他丁在相同给药剂量、给药方案下治疗细菌感染的疗效和安全性的随机对照试验(RCTs),采用Rev Man 5.2软件对入选试验进行Meta分析。结果共纳入12个随机对照试验,包括1261例细菌感染患者。Meta分析结果显示,帕尼培南/倍他米隆相比亚胺培南/西司他丁在治疗细菌感染中,临床有效率[OR=1.14,95%CI(0.85,1.53),P=0.38]与细菌清除率[OR=0.85,95%CI(0.60,1.20),P=0.36]差异均没有统计学意义。帕尼培南/倍他米隆与药物相关不良反应发生率为6.7%,亚胺培南/西司他丁为11.1%,两者差异[OR=0.59,95%CI(0.39,0.88),P=0.01<0.05]具有统计学意义。结论现有证据表明,帕尼培南/倍他米隆与亚胺培南/西司他丁在治疗细菌感染中疗效相当,前者安全性更高。     

帕尼培南／倍他米隆治疗中重度下呼吸道感染疗效观察

目的观察帕尼培南／倍他米隆治疗中、重度下呼吸感染的有效性及对痰分离细菌的体外抗菌活性。方法将83例中、重度下呼吸道细菌性感染患者单盲随机分为治疗组42例和对照组41例。治疗组用帕尼培南／倍他米隆1．0g静脉滴注,1次／12h,疗程5～7d。对照组使用哌拉西林／他唑巴坦钠4．5g静脉滴注,1次／12h,疗程5—7d。观察并比较2组的临床疗效及细菌培养结果。结果治疗组和对照组有效率分别为85．7％和80．5％,致病菌清除率分别为83．3％和75．9％,差异无统计学意义（均P〉0．05）,用药期间未出现严重药物不良反应。结论帕尼培南／倍他米隆对中、重度下呼吸道感染有较好疗效,安全性较好。     

帕尼培南-倍他米隆在血液科病人合并感染中的应用

目的:观察帕尼培南-倍他米隆在血液科病人合并感染中的治疗效果及安全性。方法:合并感染的血液科病人12例,男性7例,女性5例,年龄(53±s10)a。予帕尼培南-倍他米隆1．0～2．0 g·d-1,静脉滴注,疗程3～10 d。观察临床疗效,随访病原学检查计算清除率,同时在用药前后随访肝、肾功能等评价安全性。结果:致病菌主要包括凝固酶阴性葡萄球菌、肠杆菌、肠球菌以及肺炎克雷伯菌等。治疗有效率为75％,细菌清除率为86％。治疗中未见明显不良反应。结论:帕尼培南-倍他米隆治疗血液科病人合并感染有效且安全。     

帕尼培南-倍他米隆治疗恶性血液病细菌感染观察

目的 评价帕尼培南-倍他米隆治疗恶性血液病化疗后细菌感染的疗效与安全性。方法 以亚胺培南-西司他丁为对照药物,对两种药物治疗恶性血液病化疗后细菌感染的患者共120例的疗效和安全性进行随机对照观察。结果 帕尼培南-倍他米隆组和亚胺培南-西司他丁组的有效率分别为78．3％和80．0％．细菌清除率分别为83．3％和82．8％,两组差异无显著性。结论 帕尼培南-倍他米隆治疗恶性血液病化疗后细菌感染的疗效确切、安全。     

Panipenem/betamipron

Panipenem is a parenteral carbapenem antibacterial agent with a broad spectrum of in vitro activity covering a wide range of Gram-negative and Gram-positive aerobic and anaerobic bacteria, including Streptococcus pneumoniae and species producing beta-lactamases. Panipenem is coadministered with betamipron to inhibit panipenem uptake into the renal tubule and prevent nephrotoxicity. In large, randomised clinical trials, panipenem/betamipron demonstrated good clinical and bacteriological efficacy (similar to that of imipenem/cilastatin) in adults with respiratory tract or urinary tract infections. Panipenem/betamipron was also effective in adults with surgical or gynaecological infections, and in paediatric patients with respiratory tract and urinary tract infections in noncomparative trials. In small trials in elderly patients reported as abstracts, panipenem/betamipron demonstrated clinical efficacy similar to intravenous piperacillin and greater than oral ofloxacin in urinary tract infections. Elderly patients with respiratory tract infections also responded to therapy. Panipenem/betamipron is well tolerated with few adverse events reported in clinical trials, most commonly elevated serum levels of hepatic transaminases and eosinophils, rash and diarrhoea.     

Clinical evaluation of panipenem/betamipron in children]

Panipenem/betamipron (PAPM/BP), a new injectable carbapenem antibiotic, was evaluated for its safety and efficacy in children. Ninety three percentage (14 in 15 cases) of various infections were cured with PAPM/BP therapy. Transient skin rash occurred in 1 case, probably due to the histamine-like effect of PAPM/BP. The plasma half life of panipenem was 0.85 +/- 0.07 hours. PAPM/BP was evaluated to be a less-epileptogenic carbapenem antibiotic.     

A study on in vitro antibacterial activity and clinical usefulness in respiratory tract infections of panipenem/betamipron, a newly synthesized carbapenem antibiotic]

Panipenem/betamipron (PAPM/BP) is a combination drug of PAPM, a new parenteral carbapenem antibiotic and BP, an amino acid derivative at a weight ratio of 1:1. Its in vitro antibacterial activities against clinically isolated respiratory pathogenic bacteria were determined. It was superior to imipenem (IPM) in the in vitro antibacterial activities against Haemophilus influenzae, Haemophilus parainfluenzae, Branhamella catarrhalis, Staphylococcus aureus including MRSA, Klebsiella pneumoniae, Serratia marcescens and Escherichia coli. PAPM had antibacterial activities almost equal to those of IPM against Streptococcus pneumoniae and Enterococcus spp. Against Pseudomonas aeruginosa, however, its antibacterial activity was about 1/4 that of IPM. The clinical usefulness of PAPM/BP was studied by dissolving it in a solution containing lactate and administering the solution by intravenous drip infusion to 12 cases of respiratory tract infections. Out of 11 cases with respiratory tract infections excluding cytomegalovirus pneumonia, the efficacy rate was 90.9%, with 4 cases of excellent and 6 cases of good responses. In terms of its bacteriological efficacies, eradication of pathogenic bacteria including super-infection were observed in 2 out of 4 strains, but 2 strains of P. aeruginosa remained unchanged. Six strains appeared as superinfected bacteria during and after administration of this preparation substituting original pathogens. Side-effects were not observed in the 12 cases, and in laboratory tests, slight transient increases of S-GOT and S-GPT were found in 1 case. In conclusion, PAPM/BP is a very useful parenteral antibiotic against respiratory tract infections and can be one of the drugs of the first choice.     

Evaluation of panipenem/betamipron in pediatric field]

Panipenem/betamipron (PAPM/BP), a mixture of a newly synthesized carbapenem antibiotic panipenem (PAPM) and N-benzoyl-beta-alanine, betamipron (BP), was evaluated for pharmacokinetics, in vivo and in vitro antimicrobial effect, and clinical efficacy in pediatric patients. Intravenous drip infusion of either 10 mg/10 mg/kg or 20 mg/20 mg/kg of PAPM/BP for 30 minutes resulted in maximum plasma concentrations of 36.6 micrograms/ml and 92.5 micrograms/ml, half lives (T 1/2 beta) of 1.17 hours and 0.88 hours, and urinary excretion until 6 hours of 29% and 17.7%, respectively. Antibacterial activities of PAPM against Gram-positive cocci and Gram-negative rods isolated from pediatric patients were equal to or slightly stronger than those of imipenem, ceftazidime, cefoperazone, and piperacillin. Clinical effects of PAPM/BP evaluated in 17 patients were as follows; excellent in 8 cases, good in 8 cases, and fair in 1 case. The overall efficacy rate was 94.1%. Elevations of GOT and/or GPT were observed in 2 patients and transient eosinophilia was observed in 1 patient.     

Pharmacokinetics and clinical studies of panipenem/betamipron in the pediatric field]

Panipenem/betamipron (PAPM/BP) is a mixture of panipenem (PAPM), carbapenem antibiotic, and betamipron (BP), N-benzoyl-beta-alanine. The adverse reaction to PAPM of the kidney is reduced by the addition of BP to PAPM which inhibits the anion transport in the kidney tubules. We studied the pharmacokinetics and the clinical efficacies of PAPM/BP in children and we evaluated the antibacterial activities of PAPM by determining MIC values of PAPM in vitro against organisms isolated in our children's hospital from January to December, 1990. 1. Pharmacokinetics 10 mg/kg of PAPM/BP (10 mg PAPM/10 mg BP) was administered intravenously by drip infusion to 7 children. The mean blood concentration of PAPM was 14.8 micrograms/ml at the peak, and the mean half life was 0.9 hours in blood. PAPM was not detected in blood 3 hours after the time when the peak values were attained. 2. Clinical studies 10 mg/kg of PAPM/BP was administered intravenously 3 times a day to 18 cases including 15 of respiratory infections, 2 of otitis media and 1 of sepsis. The clinical efficacies of PAPM/BP were excellent or good in 17 out of the 18 cases. All causative organisms isolated in 5 cases, Methicillin-sensitive Staphylococcus aureus (MSSA) (1 case), Streptococcus pneumoniae (1), Haemophilus influenzae (2) and Branhamella catarrhalis (1) were eradicated in a few days upon the administrations of PAPM/BP. No adverse reactions due to PAPM/BP were observed, but a slight elevation of platelet counts in blood was observed in 1 case, which was normalized soon after the end of the treatment. 3. Antibacterial activities in vitro(ABSTRACT TRUNCATED AT 250 WORDS)