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̼ùϩǿ㣬ǿĦ-أжԦ-øȶԼԵ͵ص㣬ѾΪϸȾҪĿҩ֮һ
̼ùϩùؽṹɵһͦ-أ2080ṹùùƣ֮ͬϵԭΪ̼C2C3֮ڲ˫⣬6λһΪʽо֤Ļţʹͨùϩ˳ʽͬгġǿĿԣԼԦ-ø߶ȵȶԡ
[ҪƷ]
ѾеƷǰϡϡϡ
[ص]
һ
ǰϡϡ϶ԴԡҩԴռнǿĿԣͼʺѿȶԱƷҩǰŨ8mgL-1ʱ90%ϵҪ²϶ͳýǰ2-4ͼʺͬҩԳ˾ϸĿǰϵ2-16̼ͭٵĿǰϵ2-4϶G+Ŀǰ»ǿԳ˾ϸĿǰ£̼ͭٵĿѷǰϡ
Ԧ-øȶ
̼ùϩ鵼ijצ-øExtended-spectrum-lactamasesESBLsȾɫ弰鵼ͷ߾øAmpCøи߶ȶԡɱ-øˮ̼øϩҩ
ùؽϵPBPs
PBPϸϸĤĵӣҲǦ-ðλ̼ùϩPBPϽܶʾǿɱԡǰPBPϣPBP2ǿ谭ϸڵĺϳɣʹϸѸͣܽ⣬úܽ־PHֵ5.5-8.5Ӱ졣ѸλҪPBP2PBP3ܽϡ̼ͭٵPBPΪPBP2PBP1APBP3PBP1BPBP4.
ġڶصĹϵ
ҩյڶأٿڶյɱǿڶյ-PBPSõأǰPBP2ֻյڶͷţPBP2PBP3յڶͷˮƽǰϡѪѭڶˮƽѪѧĶйءȻڶصһЩΣصظȾˣѡҩʱӦʵԿǡ
[û]
÷ʽ ̼ùϩ÷ʽưճĺϳøùؽϵףPBPsӶ谭ϸճĺϳɣʹϸȱ𣬾ʹϸѹıϸܽɱϸ鶯ϸڣܴҩӰ죬ҩжϸѡɱãСʮ֤ʵϸĤ⵰PBPsǴҩðλǰPBPĽϣPBP2ǿ谭ϸڵĺϳɣʹϸѸܽ͡⣬úܽ־PH5.58.5Ӱ졣Ѹ볦˾ƺ̼ͭٵ߾λҪPBP2PBP3ܽϡ϶ԽϾðλPBP1PBP3Դ˾ճɳù̼ͭٵ߾ðλΪPBP2.
[ҩ]
̼ùϩΪ㡢ǿһأԶ֦ªø߶ȶͷ߾ҩԿɷáϸԸҩﲻڽҩԣԸԾԾǿĿԡ
϶ԸԾĿǰ»ǿ϶ԸԾЧϲϿԾǿ俹ԾĻǰϵ216̼ͭٵ߾ҲΪǿǰϵ4֬ϡͷ412ٴ²ⶨϵҩĿԡʾ϶ԶָԾнǿĿԣǿǰϡͷ뿡ͷडɳǡɳǣԴϣײ˾־ؾɳžξɳMIC900.080.25ug/mlǰMIC901/41/16˾˾Ŀǰ൱MIC90Ϊ0.250.5ug/mlѪоMIC90Ϊ0.125ug/mlǰMIC901/16ͷMIC901/4ԸԾòǰϣ4ֿء
[ҩԼ]
µĿҩ֣ǰϸҩԵIJȻĿǰϸ̼ùϩҩ൱ͣԳԭ൱ߣ̼ùϩ-һٴӦúҩꡣǰٴӦö꣬ҩľУƵ߾೦ͼùǰҩŧ˾С
ٴҪ²̼ùϩҩټҩҪУ1.ùؽϵ½ҪͼijЩ2.ͦ-øˮ̼ùϩԼϸ̼ùϩͨ½ҩԲҪһЩ˾ŧ˾3.п-øˮ̼ùϩ࣬ЩΪٴdzIJԭ
[ٴӦ]
̼ùϩҪʹಡˣ
1. ֢ȾԺڻԷסѪ֢ĤԼϸٵķȲˣڲԭȷǰΪ˾ǿܵIJԭΪƵѡҩԭȷɼʹãҲ"".
2. ҩȾƣESBLsꡢAmpCøͬʱESBLsAmpCøĸȾ
3. Ĵͷ߾ؼƼЧϸĸĤססѪ֢ȡ
ǰϣimipenemIMP Ʒ̩ܣǰ-˾1U1鷽оİѪ֢·ȾƸȾЧ95%ϣ֯ǹؽںǻڸȾЧ90%ºȾЧΪ85%ϸ76%-92%.иӦȨҩƷĤƣ밢Τá̩ܸҩÿ6120.5g 1.0gͯÿ12.5mg/kg.ҩٶȲ˹죬ҩ500mgʱעʱӦ30-60minϡ
ϣmeropenemMEP Ʒƽ϶Ѫ֢άϲȾڵķβȾǻȾĤȾЧϸҩΪ0.5-1gÿ6-8h1ξΣͯΪÿ6-8h10-20mg/kg.Ĥʱÿ2gÿ8h1ΣԱԼҺдﵽ㹻Ũȡ
ϣpanipenemPAPM Ʒ˱-¡1U1鷽оİѪ֢סβȾŧءȾǻȾĤȡٴЧʺϸѧЧ80%ϡ˱ҩ0.5gϼƣbidÿ2gΣͯ10-20 mg/kgÿ2-4ξΡ
[Ӧ֢]
̼ùϩҩĿ㡢ǿԺϵͳȾѪ֢ϵͳȾֳϵͳȾԼȾǻȾƤ֯ȾȶкܺõЧ
1. ҩԱҩеԸ˾ظȾɷײϣ˾ճɳȳ˾ϸ̼ͭٵ˾ϸ°Ѫ֢ºȾ·ȾǻȾǻȾȣ̼ͭٵ¸ȾʱעƳijЩɳҩ
2. ˾ϸȾ֢ߡ
3. ԭδȱݻ֢Ⱦľơ
ǰ/˾ΡʶϰϵͳӦʲϵͳȾϡ-¡Ӧ֤⣬п3ϵϸĤߡ
[ҩ]
˾ǰ1U1ãֹǰڴлԡ¡1U1ıϺãͨ¡СܷڣӶƤʵŨȣϵԡ϶ø IȶԱǰϸ4뱶¡øƼ˾á
[лй]
е̼ùϩؾΪˮҩһθҩΪ0.5g1gڴﵽ÷̵ֲҺ֭֯ңǻڣԼҺŨΪѪŨȵ816ԼҺеʣt1/2Ϊ7.4hԵѪУt1/2Ϊ1.0h˥ԼΪ1hԼΪ6075ҪйܼԴռ߾Ϳʹ˥ӳܼ˵ĻӦӦټ
˥ܣǰϡϡϰ˥ھΪԼ1СʱԼΪ60-75%Ҫйܼ˿ҩڻ˥ӳܼ˻߾ӦӦټʱҩɱӦҩ
϶øȶԱǰϺãԴˮ⡢й
[Ӧ]
̼ùϩزӦҪΪġŻ¡ʹкθӦԼѪҺѧϸࡢϸ١ϸ١ϸٵȣһΪܡʹʱɳϵͳԣͷʹʱɥʧ⾷Ρҡȣܲȫߣһ⾷λӦͣҩͬʱ̼ùϩؿɵƤȡݿ˵ȹӦ˶Թá
ǰϣ̩ܣҪΪġŻ¡кθӦƤȡȹӦϸ٣ϸ࣬ѪС٣Ѫתøߣϵͳ֢״շ߿շϣƽҪΪƤסӦͷʹѪС࣬ϸ࣬ѪתøAKPLDHߵȣż0.05%Զǰϣʶϰϵͳ֢״ȵزӦʽ٣һ0.1%ϣ˱ҪΪġŻ¡кθӦƤҩȡȵӦ
ݿ˷ʵͣӦע⡣ùࡢͷ߾༰-ҩߣ̼ܶùϩسֽԶҩȫԹӦߣӦñҩ
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ڶԱҩPɷֹĻߡ
[ע]
1. ҩﲻ֢ȾΪԤҩ
2. ҩµϵͳӦԭʷϵͳܿԴռ˻δҩߣԭϵͳ߱ӦñҩϵͳȾĻָӦϻʱܹ۲鴤زӦ
3.ܲȫӦñҩʱӦܼ˳̶ȼҩ
[ҩ]
껼ӦñҩʱӦܼ˳̶ȼҩ