Research progress in pharmacokinetics/pharmacodynamics and therapeutic drug monitoring of biapenem
- VernacularTitle:比阿培南药动学/药效学和治疗药物监测的研究进展
- Author:
Xinglong TAO
1
;
Yu ZHANG
2
;
Xikun WU
1
;
Xiaosong MA
3
;
Tiantian ZHANG
1
;
Xia WU
1
;
Weichong DONG
1
;
Ning SONG
2
;
Zhiqing ZHANG
1
Author Information
1. Dept. of Pharmacy，the Second Hospital of Hebei Medical University，Shijiazhuang 050200，China
2. Dept. of Infectious Diseases，the Second Hospital of Hebei Medical University，Shijiazhuang 050200，China
3. Dept. of Preventive Health Care，the Second Hospital of Hebei Medical University，Shijiazhuang 050200，China
- Publication Type:Journal Article
- Keywords:
biapenem;
pharmacokinetics;
pharmacodyna-
- From:
China Pharmacy
2023;34(15):1915-1920
- CountryChina
- Language:Chinese
-
Abstract:
Biapenem is a carbapenem antibiotic， and can be used for the treatment of sepsis， pneumonia， lung abscess， chronic respiratory lesions secondary infection， complex urinary tract infection and pyelonephritis， etc. This article reviewed the studies on the pharmacokinetics， pharmacodynamics and therapeutic drug monitoring （TDM） of biapenem. The pharmacokinetic parameters of biapenem are not significantly different in healthy subjects， and there is no accumulation after multiple doses of biapenem. However， there are large differences in pharmacokinetic parameters in patients with severe disease and patients with abnormal renal function compared with healthy subjects， which leads to conventional treatment regimens not achieving the desired outcome. In terms of pharmacodynamics， biapenem can improve the rate of reaching the target value by increasing the frequency of administration and prolonging the infusion time. For patients with anuria in end-stage renal disease， dosing intervals can be extended to avoid drug accumulation. However, for patients with severe infection, a daily dose of 1.2 g still can not control infections caused by Acinetobacter baumannii or Pseudomonas aeruginosa, which limits its use in patients with severe disease. It is recommended to implement TDM in severe patients and patients with abnormal renal function， and explore the best dosing regimen for biapenem in combination with pharmacokinetic models to ensure that the time that the free blood concentration of biapenem remains above minimum inhibitory concentration as a percentage of the time between doses （%fT＞MIC） is within the effective range，so that biapenem can exert a greater efficacy in severe patients and patients with abnormal renal function. For medical institutions that cannot carry out TDM， the efficacy of biapenem can be maximized by increasing the frequency of administration and prolonging the infusion time. For infections caused by P. aeruginosa， A. baumannii and Serratia marcescens with high drug resistance rates， it is recommended to combine or replace other antibiotics.
