PMID- 28789493
OWN - NLM
STAT- MEDLINE
DCOM- 20181127
LR  - 20190318
IS  - 0578-1426 (Print)
IS  - 0578-1426 (Linking)
VI  - 56
IP  - 8
DP  - 2017 Aug 1
TI  - [The reliability of using impenem, meropenem, cefoperazone-sulbactam and 
      piperacillin-tazobactam to treat nosocomial Gram-negative bacterial infections 
      with Monte Carlo simulation].
PG  - 595-600
LID - 10.3760/cma.j.issn.0578-1426.2017.08.008 [doi]
AB  - Objective: To evaluate the reliability of using imipenem, meropenem, 
      cefoperazone-sulbactam, piperacillin-tazobactam in the treatment of 
      hospital-acquired Gram-negative bacterial infections with Monte Carlo 
      simulation(MCS). Methods: The MIC of the four agents collected from 
      hospital-acquired infections were detected in accordance with broth dilution 
      method of Clinical and Laboratory Standard Institute (CLSI). MCS were conducted 
      with MICs and the pharmacokinetics parameters of the four agents based on 
      conventional dose regimens.The cumulative fraction of response (CFR) of time over 
      MIC target attainment in different dosing regimen were generated. Results: A 
      total of 2 541 strains, including 2 093 strains of Enterobacteriaceae and 448 
      strains of glucose non-fermentative bacilli were collected.The MIC(90) of 
      imipenem and meropenem against Enterobacteriaceae were less than 1 mg/L in 
      general, whereas MIC(90) of two agents with beta-lactamase inhibitors was around 64 
      mg/L.As to glucose non-fermenting bacteria, MICs of all the four agents were very 
      high, especially to Acinetobacter baumannii, which indicated MIC(50) more than 32 
      mg/L.MCS revealed that carbapenems had significantly higher CFR than those with 
      beta-lactamase inhibitors.Imipenem and meropenem (1 g, q8 h) obtained CFRs of 74.69% 
      and 81.42%, respectively.The CFR of cefoperazone-sulbactam (2 g, q8 h) and 
      piperacillin-tazobactam (4 g, q6 h) (both excluding beta-lactamase inhibitors) were 
      just 49.59% and 27.66% respectively, which increased after excluding A. baumannii 
      in piperacillin-tazobactam. Conclusions: The conventional dose regimens of 
      imipenem and meropenem are reliable for the empiric therapy of Gram-negative 
      hospital-acquired bacterial infections.Piperacillin-tazobactam is suggested to 
      use with higher doses or prolonged infusion time to satisfy the time of drug 
      concentration exceeded the MIC(T>MIC)requirement.More clinical studies of 
      cefoperazone-sulbactam should be conducted to optimize its regimen and guarantee 
      its efficacy.
FAU - Xiao, Y H
AU  - Xiao YH
AD  - Collaborative Innovation Center for Diagnosis & Treatment of Infectious Diseases, 
      State Key Laboratory for Diagnosis & Treatment of Infectious Diseases, the First 
      Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, 
      China.
FAU - Hu, Y J
AU  - Hu YJ
LA  - chi
PT  - Journal Article
PL  - China
TA  - Zhonghua Nei Ke Za Zhi
JT  - Zhonghua nei ke za zhi
JID - 16210490R
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Thienamycins)
RN  - 157044-21-8 (Piperacillin, Tazobactam Drug Combination)
RN  - 7U75I1278D (Cefoperazone)
RN  - 87-53-6 (Penicillanic Acid)
RN  - FV9J3JU8B1 (Meropenem)
RN  - S4TF6I2330 (Sulbactam)
RN  - X00B0D5O0E (Piperacillin)
SB  - IM
MH  - Anti-Bacterial Agents/administration & dosage/*pharmacology
MH  - Cefoperazone/administration & dosage/*pharmacology
MH  - Cross Infection/*drug therapy/microbiology
MH  - Gram-Negative Bacteria/*drug effects/isolation & purification
MH  - Gram-Negative Bacterial Infections/*drug therapy/microbiology
MH  - Humans
MH  - Meropenem
MH  - Microbial Sensitivity Tests/methods
MH  - Monte Carlo Method
MH  - Penicillanic Acid/administration & dosage/*analogs & derivatives/pharmacology
MH  - Piperacillin/administration & dosage/pharmacology
MH  - Piperacillin, Tazobactam Drug Combination
MH  - Reproducibility of Results
MH  - Sulbactam/administration & dosage/*pharmacology
MH  - Thienamycins/administration & dosage/*pharmacology
OTO - NOTNLM
OT  - Cefoperazone-sulbactam
OT  - Imipenem
OT  - Meropenem
OT  - Monte Carlo simulation
OT  - Pharmacokinetics/pharmacodynamics
OT  - Piperacillin-tazobactam
EDAT- 2017/08/10 06:00
MHDA- 2018/11/28 06:00
CRDT- 2017/08/10 06:00
PHST- 2017/08/10 06:00 [entrez]
PHST- 2017/08/10 06:00 [pubmed]
PHST- 2018/11/28 06:00 [medline]
AID - 10.3760/cma.j.issn.0578-1426.2017.08.008 [doi]
PST - ppublish
SO  - Zhonghua Nei Ke Za Zhi. 2017 Aug 1;56(8):595-600. doi: 
      10.3760/cma.j.issn.0578-1426.2017.08.008.