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。     

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。     

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-倍他米隆治疗恶性血液病细菌感染临床分析

目的分析探讨帕尼培南-倍他米隆治疗恶性血液病细菌感染的临床疗效。方法对我院2009年1月至2010年12月收治的35例恶性血液病患者采用帕尼培南-倍他米隆进行治疗,并与亚胺培南-西司他丁治疗组进行疗效比较。结果观察组的总有效率为77.14%,对照组的总有效率为78.79%;观察组的细菌清除率为90.00%,对照组的细菌清除率为89.47%;两组患者均出现4例药物不良反应,观察组及对照组的药物不良反应的发生率分别为11.43%、12.12%。三组数据进行差异比较,均无统计学意义(P>0.05)。结论采用帕尼培南-倍他米隆对恶性血液病细菌感染进行治疗,既安全又有效,值得在临床上推广应用。     

帕尼培南倍他米隆对血液肿瘤儿童伴粒细胞缺乏症抗感染治疗的疗效及其对致病菌清除的影响

目的:评价帕尼培南倍他米隆对血液肿瘤儿童伴粒细胞缺乏症抗感染治疗的疗效及其对致病菌清除的影响。方法:选取2016年11月—2017年11月间收治的血液肿瘤伴粒细胞缺乏症感染患儿58例资料,按照随机抽签方式将其分为观察组和对照组,每组29例;观察组患儿给予帕尼培南倍他米隆治疗,对照组患儿给予亚胺培南-西司他丁治疗,比较两组患儿治疗后的总有效率的差异,以及对致病菌清除的影响。结果:观察组患儿治疗后的总有效率为93.10%显著高于对照组为72.41%(χ~2=4.350,P<0.05),用药期间不良反应的发生率明显低于对照组(χ~2=4.062,P<0.05),细菌清除率为94.74%显著高于对照组为66.67%(χ~2=4.912,P<0.05)。结论:采用帕尼培南倍他米隆治疗血液肿瘤伴粒细胞缺乏症患者抗感染的临床疗效果确切,有效清除了致病菌,安全性较高。     

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-倍他米隆在呼吸系统感染病人体内的药动学研究

目的 :研究帕尼培南 倍他米隆在 13名呼吸系统感染病人体内的药动学。方法 :静脉滴注帕尼培南 倍他米隆 (0 .5 +0 .5 ) g后 ,采用高效液相色谱 (HPLC)方法测定帕尼培南、倍他米隆的血药浓度 ,计算药动学参数。结果 :帕尼培南的药动学参数T12 α,T12 β,AUC ,Cls,Vd 分别为 (0 .34±s 0 .18)h ,(1.4± 0 .3)h ,(4 3± 7)h·mg·L- 1,(11.8± 1.9)L·h- 1,(12± 4 )L。倍他米隆的药动学参数T12 α,T12 β,AUC ,Cls,Vd 分别为 (0 .10± 0 .0 5 )h ,(0 .6 3± 0 .2 0 )h ,(19± 6 )h·mg·L- 1,(30± 11)L·h- 1,(11± 5 )L。结论 :HPLC方法简便、快捷、灵敏、准确 ,适用于帕尼培南 倍他米隆临床药动学及药效学的研究。     

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。     

Clinical evaluation of panipenem/betamipron in severe infections complicating hematological disorders]

Forty-three patients with severe infections which were complicating hematological disorders were treated with panipenem/betamipron, and the efficacy and the safety of the drug were evaluated. The results obtained are summarized below. 1. Out of 40 patients in whom efficacies are evaluable, the clinical responses were excellent in 17 patients, good in 4, fair in 7 and poor in 12, and the total clinical efficacy rate was 52.5%. 2. The efficacy rate in 7 patients who had failed to respond to prior treatment with other antibiotics was 57.1%. Thus, no significant difference was observed in efficacy rates between the patients who had failed to respond to prior treatment with other antibiotics and the patients who received no preceding antibiotics therapy. 3. Out of the 43 patients in whom the safety was evaluable, no side effects nor abnormal laboratory findings were found.     

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。     

Clinical study of panipenem/betamipron for burn infections in the domain of plastic and reconstructive surgery]

The effectiveness and the safety of panipenem/betamipron, new antibiotics of the carbapenems for burn infections, were studied and the following results were obtained: 1. The preparation, 0.5 g/0.5 g, was administered by intravenous drip infusion twice a day to 11 cases of patients with burn infections. In 10 cases for which clinical effects were evaluable, results were rated as "excellent" in 2 cases, "good" in 2 cases and "fair" in 6 cases, with an efficacy rate of 40%. 2. Penetration to the affected tissue was studied in 2 cases. The tissue level of panipenem was 0.20 micrograms/g immediately after the end of drip infusion and 6.86 micrograms/g 60 minutes thereafter. 3. As for the safety, a slight increase in GOT, GPT and Al-P was noted in 1 case; a slight increase in GPT, NAG and beta 2MG was found in 1 case; and a slight increase in GOT, GPT, Al-P and LAP was noted in 1 case, as abnormal variations in laboratory test results.     

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.     

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.     

Bacteriological and clinical studies of panipenem/betamipron in pediatrics]

We carried out bacteriological and clinical studies of panipenem/betamipron (PAPM/BP), a newly-developed carbapenem antibiotic, in pediatrics, and the following results were obtained: 1. When antibacterial activities of panipenem (PAPM) were determined, it was found that MICs against such Gram-positive cocci as Staphylococcus aureus and Streptococcus pneumoniae and against such Gram-negative rods as Escherichia coli, Haemophilus influenzae, Pseudomonas aeruginosa, and Branhamella catarrhalis were all sufficiently low. 2. PAPM showed better MIC-correlated antibacterial activities against 215 subcultured strains of methicillin-resistant S. aureus (MRSA) than imipenem. 3. Clinical efficacies were evaluated to be excellent in 23 of 34 patients treated with PAPM/BP, excluding 3 patients from the efficacy evaluation. In addition, good responses were obtained in 10 patients but poor response in one, showing the overall efficacy rate of 97.1%. As for bacteriological efficacies, the eradication rate was also determined to be high, 92.6%. 4. As for side effects, rash appeared in 2 patients, and soft stool and diarrhea occurred in one each. The overall incidence of side effects was calculated to be 10.8%. As for abnormal laboratory findings, increases of eosinophiles in 4 patients, thrombocytes in 2, total bilirubin in 1, and GOT in 1 were observed. From these results, PAPM/BP was thought to be a highly useful drug in pediatrics.