回顾性评估头孢美唑治疗产超广谱β-内酰胺酶大肠埃希菌所致侵袭性尿路感染的适宜剂量。
Retrospective evaluation of appropriate dosing of cefmetazole for invasive urinary tract infection due to extended-spectrum β-lactamase-producing Escherichia coli.
机构信息
Department of Pharmacy, Tokyo Women's Medical University Hospital, Tokyo, 162-866, Japan.
Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
出版信息
J Infect Chemother. 2021 Nov;27(11):1602-1606. doi: 10.1016/j.jiac.2021.07.009. Epub 2021 Aug 1.
INTRODUCTION
The frequency of urinary tract infections (UTIs) caused by extended-spectrum β-lactamase (ESBL)-producing Enterobacterales is steadily increasing worldwide. Therefore, we aimed to evaluate the efficacy and appropriate dosing of cefmetazole (CMZ) in invasive urinary tract infection (iUTI) caused by ESBL-producing Escherichia coli (ESBLEC).
METHODS
Patients who developed ESBLEC iUTI and received CMZ between January 2007 and December 2018 were identified, and their medical records were reviewed. The time above minimum inhibitory concentration (MIC) (TAM) was calculated using the MIC value obtained from each patient and its simulated CMZ concentration.
RESULTS
Thirty-nine patients were included in the study. The median TAM was 92.6% (interquartile range [IQR], 67.6-100). CMZ was clinically efficacious in 38 (97.4%) patients overall and in 11 out of 12 (91.7%) patients with normal renal function who received CMZ at 1 g every 8 h.
CONCLUSIONS
In normal renal function, 1 g CMZ infused for over 1 h every 8 h is an efficacious treatment for iUTI caused by ESBLEC with MIC =< 4 mg/L.
介绍
产超广谱β-内酰胺酶（ESBL）的肠杆菌科细菌引起的尿路感染（UTI）的频率在全球范围内稳步上升。因此，我们旨在评估头孢美唑（CMZ）在产 ESBL 的大肠埃希菌（ESBLEC）引起的侵袭性尿路感染（iUTI）中的疗效和适当剂量。
方法
确定了 2007 年 1 月至 2018 年 12 月期间因 ESBLEC 而发生 iUTI 并接受 CMZ 治疗的患者，并回顾了其病历。使用从每位患者获得的 MIC 值及其模拟的 CMZ 浓度计算超过最低抑菌浓度（MIC）时间（TAM）。
结果
本研究共纳入 39 例患者。中位 TAM 为 92.6%（四分位距[IQR]，67.6-100）。CMZ 在整体 38 例（97.4%）患者中具有临床疗效，在 12 例肾功能正常的患者中（91.7%）也具有临床疗效，这 12 例患者接受了 1 g 每 8 h 一次的 CMZ 治疗。
结论
在肾功能正常的情况下，每 8 h 输注超过 1 h 的 1 g CMZ 是 MIC =< 4 mg/L 的 ESBLEC 引起的 iUTI 的有效治疗方法。
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