β-内酰胺类抗生素无菌检查方法学研究

目的建立β-内酰胺类抗生素的无菌检查方法。方法采用薄膜过滤法,以不同冲洗量,联合加入β-内酰胺酶以消除抗生素的抑菌活性。结果样品、阴性对照无菌生长,所有阳性对照及试验组菌在2d内生长良好。结论针对β-内酰胺类抗生素做无菌检查时,无论品种、规格,均可配成约20mg·mL^-1后按薄膜过滤法操作,根据抗生素对β-内酰胺酶的稳定性适量加入β-内酰胺酶可减少冲洗液用量,以获得最佳的无菌检查方法。     

美罗培南无菌检查的方法学验证

目的建立美罗培南的无菌检查标准方法。方法根据中国药典2010年版附录ⅪH无菌检查法中的要求,采用薄膜过滤法进行方法学验证。结果每筒冲洗量600ml（分6次）,人工振荡,可以消除样品对6株实验菌的抗菌活性。结论美罗培南采用薄膜过滤法,总冲洗量为1800ml,采取人工振荡,可以用大肠埃希菌作为阳性对照菌进行无菌检测。     

阿莫西林胶囊微生物检查方法学研究

目的 为了建立有效、操作简单、成本低廉的阿莫西林胶囊微生物限度和控制菌检查方法。方法 采用平皿法、稀释法、薄膜过滤法、中和法共14种方法对阿莫西林胶囊进行微生物限度方法适用性研究，比较了稀释法、薄膜过滤法和中和法去除阿莫西林胶囊抑菌性的能力；考察了聚山梨酯80、卵磷脂和β-内酰胺酶作为中和剂去除其抑菌性的能力；并考察了将中和剂添加于稀释剂、冲洗液、培养基中去除抑菌性的能力。采用直接接种法、中和法共7种方法进行了控制菌方法适用性研究。结果 建立阿莫西林胶囊微生物限度和控制菌检查方法。结论 可采用在稀释剂TSB中添加1115万单位β-内酰胺酶的方法对阿莫西林胶囊进行需氧菌总数检查。     

冰石愈伤软膏无菌检查方法验证

目的建立冰石愈伤软膏的无菌检查方法并对方法进行验证。方法按2005年版《中国药典(一部)》软膏剂项下要求进行试验,采用薄膜过滤法,冲洗量为300 mL。结果样品管无菌生长,6株阳性对照菌生长良好。结论采用薄膜过滤法验证试验进行冰石愈伤软膏的无菌检查,方法有效、可行。     

β-环糊精在喹诺酮类抗生素药品微生物限度检查方法建立中的应用

目的:研究β-环糊精对喹诺酮类抗生素药品抑菌性的中和作用,建立喹诺酮类抗生素药品微生物限度检查方法。方法:以β-环糊精为中和剂,采用薄膜过滤法对喹诺酮类抗生素药品进行微生物限度方法学研究。结果:β-环糊精对喹诺酮类抗生素药品的抑菌性有较好的中和作用,经过实验,5株验证菌回收率均在70%以上。结论:β-环糊精可作为消除喹诺酮类抗生素药品抑菌活性的中和剂,解决该类药品微生物限度检查方法建立困难问题。     

头孢克洛干混悬剂微生物限度检查方法的建立及验证

目的:建立头孢克洛干混悬剂微生物限度检查方法并进行方法验证。方法:根据2010年版《中国药典》二部附录微生物限度检查方法中的常规法和薄膜过滤法,对头孢克洛干混悬剂进行方法验证,通过比较回收率来确定适宜的计数方法,通过比较对供试液一般处理和加入β-内酰胺酶进行处理的试验结果来确定控制菌检查方法。结果:采用常规法试验,样品对细菌的回收率为0,对霉菌及酵母菌的回收率均高于70%;采用薄膜过滤法试验,加入pH 7.0无菌氯化钠-蛋白胨缓冲液400 ml、每次100 ml进行冲洗,细菌的回收率均大于80%;采用薄膜过滤加入β-内酰胺酶的方法,控制菌生长良好,可有效消除头孢克洛干混悬剂的抑菌作用。结论:头孢克洛干混悬剂可采用常规法测定霉菌和酵母菌数;用薄膜过滤法测定细菌数;用薄膜过滤加入β-内酰胺酶的方法进行控制菌检查。     

头孢菌素类无菌检查中酶处理探讨

目的：通过验证试验建立头孢菌素类无菌检查法。方法：按2005年版《中国药典》规定，采用薄膜过滤法对10种不同代注射用头孢菌素进行系统的无菌检查方法研究。结果：不同代头孢菌素因抗菌谱的差异，对阳性对照菌，冲洗量及青霉素酶的加入方法等条件有显著不同。结论：头孢菌素类药的无菌检查方法可加入适量β-内酰胺酶（青霉素酶），提高阳性检出率，确保无菌实验结果的可信度。     

甲硝唑注射液无菌检查方法学验证

目的：建立甲硝唑注射液的无菌检查方法。方法：采用薄膜过滤法，以不同冲洗量，联合加入表面活性剂等方法以消除甲硝唑的抑菌活性。结果：样品、阴性对照无菌生长，所有阳性对照及试验组菌在2d内生长良好。结论：薄膜过滤法可以用于无菌检查，检查时甲硝唑注射液以伽．2％聚山梨酯80的冲洗液500ml 5次冲洗后依法培养，生孢梭菌为阳性对照菌。     

替硝唑栓微生物限度检查方法学研究

目的：对替硝唑栓的微生物限度检查方法进行研究。方法按照《中华人民共和国药典》2010年版附录的要求进行方法学验证,细菌计数采用低速离心-薄膜过滤法,真菌及酵母菌计数采用薄膜过滤法,控制菌检查采用薄膜过滤法与低速离心-薄膜过滤法。结果细菌、真菌及酵母菌的回收率均〈70.0%,控制菌检查中,各阳性试验菌均检出,阴性对照无菌生长。结论薄膜过滤法与低速离心-薄膜过滤法可消除替硝唑栓的抑菌作用,适用于该制剂的微生物限度检查。     

盐酸左氧氟沙星注射液的无菌实验方法验证

目的建立盐酸左氧氟沙星注射液的无菌检查的方法。方法用薄膜过滤法进行。结果阳性对照菌24h内全部正常生长,阴性对照及样品澄清无菌生长,试验组检出试验菌。结论盐酸左氧氟沙星注射液的无菌检查,可采用薄膜过滤法,用pH 7.0氯化钠-蛋白胨稀释液冲洗,冲洗量800mL,每次50mL。     

美罗培南三水合物的合成

目的合成碳青霉烯类抗生素美罗培南.方法以羟脯氨酸为起始原料,经5步反应合成得到侧链(2S,4S)-二甲氨基甲酰基-4-巯基-1-(4-硝基苯甲氧羰基)吡咯烷(V),V与(1R,5R,6S)-2-(二苯氧基磷酰氧基)-6-[(R)-1-羟乙基]-1-甲基碳青霉-2-烯-3-羧酸对硝基苄酯(Ⅵ)经取代、氢化、大孔吸附树脂柱色谱纯化得到美罗培南三水合物,总收率为13.9%(以羟脯氨酸计).结果与结论合成了美罗培南三水合物,其结构经质谱、核磁共振氢谱和热重分析确证.     

美罗培南的体外抗菌活性研究

目的 评价国产美罗培南对产β-内酰胺酶细菌的体外抗菌活性。方法 琼脂稀释法测定美罗培南对110株产β-内酰胺酶临床分离菌的最低抑菌浓度(MIC)。并与相关抗菌药物进行比较。结果 碳青霉烯类抗生素对产β-内酰胺酶菌株具有高度抗菌活性，国产美罗培南作用略强于亚胺培南。碳青霉烯类抗生素体外抗菌作用优于头霉素、第四代头孢菌素、β-内酰胺类抗生素与β-内酰胺酶抑制剂合剂、喹诺酮类和氨基糖苷类药物。结论 国产美罗培南是治疗产β-内酰胺酶细菌所致感染的理想药物。     

Safety profile of meropenem: an updated review of over 6,000 patients treated with meropenem.

Meropenem is a broad-spectrum carbapenem antibacterial with potent antimicrobial activity against a broad range of Gram-negative, Gram-positive and anaerobic bacteria. The second parenteral carbapenem to be introduced worldwide, meropenem has been in clinical use since 1994. Two previous safety reviews have established that meropenem has a favourable and acceptable safety profile. This new review was conducted after the approval of meropenem in the US in 2005 for the treatment of patients with complicated skin and skin-structure infections, in addition to the previously approved indications of intra-abdominal infections and paediatric bacterial meningitis. The analysis includes the clinical trial data from the previous safety reviews, updated with expanded experience across a number of serious bacterial infections, including a large international study in patients with skin or skin-structure infections and further experience in patients with intra-abdominal infections and bacterial meningitis. A total of 6154 patients with 6308 meropenem exposures were compared with 4483 patients treated with comparator agents (4593 exposures), and the paediatric population base for which safety data are available has doubled to over 1000 patients. The data presented reinforce the favourable safety profile of meropenem. In general, the incidence and pattern of adverse events occurring with meropenem were similar to those of the first carbapenem, imipenem/cilastatin, and to those of the cephalosporin- and clindamycin-based regimens to which it had been compared. The most common adverse events reported for meropenem were diarrhoea (2.5%), rash (1.4%) and nausea/vomiting (1.2%). No adverse event occurred in more than 3% of patient exposures to meropenem, indicating a low overall frequency of adverse events as well as excellent gastrointestinal tolerability. Furthermore, no unexpected adverse events were identified, and the very low incidence of seizures in patients with meningitis was not considered to be drug related. In infections other than meningitis, the incidence of seizures considered by investigators to be related to meropenem treatment was 0.07%. In the new studies that updated the earlier safety data, no new cases of drug-related seizure were reported for any treatment or patient group (meningitis/non-meningitis infections). In conclusion, meropenem is well tolerated and has good CNS and gastrointestinal tolerability when used for the treatment of serious bacterial infections in a wide range of adult and paediatric patient populations.     

Intrapulmonary pharmacokinetics and pharmacodynamics of meropenem

The objective of this study was to determine the plasma and intrapulmonary pharmacokinetic parameters of intravenously administered meropenem in healthy volunteers. Four doses of 0.5 g, 1.0 g or 2.0 g meropenem were administered intravenously to 20, 20 and 8 healthy adult subjects, respectively. Standardised bronchoscopy and timed bronchoalveolar lavage (BAL) were performed following administration of the last dose. Blood was obtained for drug assay prior to drug administration and at the time of BAL. Meropenem was measured in plasma, BAL fluid and alveolar cells (ACs) using a combined high pressure liquid chromatographic–mass spectrometric technique. Plasma, epithelial lining fluid (ELF) and AC pharmacokinetics were derived using non-compartmental methods. C_max/MIC₉₀ (where C_max is the maximum plasma concentration and MIC₉₀ is the minimum inhibitory concentration required to inhibit 90% of the pathogen), AUC/MIC₉₀ (where AUC is the area under the curve for the mean concentration–time data), intrapulmonary drug exposure ratios and percent time above MIC₉₀ during the dosing interval (%T > MIC₉₀) were calculated for common respiratory pathogens with MIC₉₀ values of 0.12–4 μg/mL. In the 0.5 g dose group, the C_max (mean ± S.D.), AUC_0–8 h and half-life for plasma were, respectively, 25.8 ± 5.8 μg/mL, 28.57 μg h/mL and 0.77 h; for ELF the values were 5.3 ± 2.5 μg/mL, 12.27 μg h/mL and 1.51 h; and for ACs the values were 1.0 ± 0.5 μg/mL, 4.30 μg h/mL and 2.61 h. In the 1.0 g dose group, the C_max, AUC_0–8 h and half-life for plasma were, respectively, 53.5 ± 19.7 μg/mL, 55.49 μg h/mL and 1.31 h; for ELF the values were 7.7 ± 3.1 μg/mL, 15.34 μg h/mL and 0.95 h; and for ACs the values were 5.0 ± 3.4 μg/mL, 14.07 μg h/mL and 2.17 h. In the 2.0 g dose group, the C_max, AUC_0–8 h and half-life for plasma were, respectively 131.7 ± 18.2 μg/mL, 156.7 μg h/mL and 0.89 h. The time above MIC in plasma ranged between 28% and 78% for the 0.5 g dose and between 45% and 100% for the 1.0 g and 2.0 g doses. In ELF, the time above MIC ranged from 18% to 100% for the 0.5 g dose and from 25% to 88% for the 1.0 g dose. In ACs, the time above MIC ranged from 0% to 100% for the 0.5 g dose and from 24% to 100% for the 1.0 g dose. Time above MIC in ELF and ACs for the 2.0 g dose was not calculated because of sample degradation. The prolonged T > MIC₉₀ and high intrapulmonary drug concentrations following every 8 h administration of 0.5–2.0 g doses of meropenem are favourable for the treatment of common respiratory pathogens.     

Pharmacokinetics of meropenem in preterm neonates

The objective of this study was to evaluate and compare the pharmacokinetics of meropenem in premature neonates, both after the first dose and during steady state at day 5, after a 1-minute intravenous administration to evaluate the possibility of twice-daily administration. Seven premature neonates received 15 mg/kg meropenem twice daily on clinical grounds as a 1-minute infusion. After the first dose and during steady state at day 5, serum levels of meropenem were measured for 12 hours after intravenous administration. Meropenem pharmacokinetics at the first dose were studied in seven children (mean birth weight 925 g, mean postnatal age 21 days). Serum concentration-time curves could be described with a one-compartment model. Mean total body clearance was 0.157 L/kg per hour, volume of distribution was 0.74 L/kg, and half-life was 3.4 hours. At day 5 at steady state, pharmacokinetic properties did not differ significantly. No side effects were noted. A 1-minute intravenous administration is feasible. Pharmacokinetic properties are comparable at day 5 compared with the first dose, and half-life is such that twice-daily administration of 15 mg/kg produces adequate serum concentrations.     

注射用美罗培南的质量评价

摘要：目的 评价注射用美罗培南的质量现状,为其生产、质控、监管提供参考。方法 按照国家药品质量评价性抽验计 划要求,采用法定标准检验结合探索性研究的方式,对包括原研企业在内的11家生产企业100批次样品进行质量考察。结果 按 法定标准检验合格率100%,普通国产制剂与原研产品及通过仿制药一致性评价的产品,在制剂碳酸钠含量的均匀性和丙酮残留 量等方面仍存在一定的质量差异。现行的7个质量标准中,检验项目不同,检验方法和标准限度不统一。结论 注射用美罗培南 的总体质量趋好,仿制制剂质量水平与原研药仍存在差距,通过对制剂包材及相容性的研究可以进一步提高产品的质量。     

美罗培南新发及严重不良反应综述

本文以美罗培南、不良反应、安全性等为关键词,组合查询在中国知网、维普、万方、大医网、Pubmed等数据库中的相关文献,对美罗培南新发及严重的不良反应(ADR)进行归纳与总结,旨在指导美罗培南的临床合理用药。相关文献研究表明,美罗培南除说明书中记载的主要ADR外,还存在许多新发及严重的ADR,且涉及到多个系统。临床医师在应用美罗培南时,应加强对患者的肝肾功能及血常规的监测,出现新发及严重的ADR时应及时处理,确保患者的用药安全。     

国产美洛培南的体外抗菌活性

采用琼脂二倍稀释法测定国产美洛增南和其它５种药物对１３６株临床分离菌的体外抗菌活性,结果表明国产美洛增南与进口美洛增南的体外抗菌活性相近,优于头孢哌酮／舒巴坦、他唑西林和头孢他啶。国产美洛增南对金葡萄菌、铜绿假单孢菌、大肠埃希氏菌和肺炎克雷伯氏菌的抗菌活性优于亚胺培南／西司他丁,对表葡球菌和β－溶血性链球菌的抗菌活性比后者稍差。国产美洛培南的抗菌活性稍受接种菌量、培养基ｐＨ和血清浓度影响。     

美罗培南个体化给药的研究进展

美罗培南作为第二代碳青霉烯类抗生素往往是治疗严重感染的最后选择,其个体化给药的研究近年来备受关注.药代/药效学(PK/PD)参数可用于优化美罗培南给药方案,但美罗培南的体内代谢和消除受多种因素影响,因此需进行群体药代动力学(PPK)研究以更好地表证个体差异.利用PPK模型,结合患者个体资料、病原菌最低抑菌浓度(MIC)和临床药效学参数可实现美罗培南的个体化给药,从而在保证疗效的前提下避免治疗过度.本文就近年来美罗培南个体化给药的研究进展作一综述.