舒巴坦度洛巴坦治疗耐碳青霉烯类鲍曼不动杆菌肺部感染的临床效果及药物浓度监测

Clinical efficacy of sulbactam-durlobactam in treating patients with carbapenem-resistant Acinetobacter baumannii pulmonary infection and drug concentration surveillance

    摘要
  • 摘要:
    目的 探讨舒巴坦度洛巴坦联合美罗培南治疗碳青霉烯耐药的鲍曼不动杆菌(CRAB)肺部感染的疗效。
    方法 纳入中日友好医院2025年1月1日-6月1日治疗的16例患者, 回顾性分析患者基本情况、前期治疗方案、与感染治疗相关诊断和病原学及临床转归情况, 并对舒巴坦进行了治疗药物监测。
    结果 13例患者在疗程结束时达到CRAB病原学清除和临床好转, 1例患者在一个月内出现CRAB复发。3例患者治疗失败。13例患者进行了舒巴坦的治疗药物监测, 除1例患者略低外, 均达到血药谷浓度在最小抑菌浓度(MIC)之上(100%T>MIC, 按临床折点计算, MIC=4 mg/L)。4例患者根据血药浓度调整剂量, 3例减量, 1例增加剂量。
    结论 舒巴坦度洛巴坦联合美罗培南治疗CRAB疗效显著。该药在说明书用法用量下, 患者均可达到舒巴坦PK/PD目标。

     

    Abstract:
    OBJECTIVE To evaluate the efficacy of sulbactam-durlobactam combined with meropenem in treating carbapenem-resistant Acinetobacter baumannii (CRAB) pulmonary infection.
    METHODS A total of 16 patients treated at China-Japan Friendship Hospital from Jan. 1, 2025 to Jun. 1, 2025 were included. Retrospective analysis was conducted on patients′ basic situation, preliminary treatment regimens, infection-related diagnoses, etiology and clinical outcomes. Therapeutic drug monitoring (TDM) for sulbactam was also performed.
    RESULTS By the end of the treatment course, 13 patients achieved etiological eradication of CRAB and clinical improvement, while 1 patient experienced CRAB recurrence within one month. Three patients showed treatment failure. TDM for sulbactam was performed in 13 patients. Except for one slightly lower, all achieved trough plasma concentrations above the minimum inhibitory concentration (MIC) (100% T > MIC, MIC = 4 mg/L based on clinical breakpoints). Dosage adjustments based on plasma concentrations were made for 4 patients, with 3 receiving reduced doses and 1 receiving an increased dose.
    CONCLUSIONS Sulbactam-durlobactam combined with meropenem demonstrates superior efficacy in treating CRAB compared to other regimens. Under the recommended dosage, all patients can achieve the PK/PD target for sulbactam.

     

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