Objective To evaluate whether individualized dosage regimen based on therapeutic drug monitoring (TDM) is beneficial for improving the rate of pharmacokinetics/pharmacodynamics (PK/PD) reaching the standard and anti-infection efficacy. Methods Totally, 36 cases in the intensive care unit ( ICU ) of Nanjing Drum Tower Hospital using meropenem during January 2015 to December 2015 were collected, and divided into intervention group and control group. Results On the fourth day of administration, meropenem concentration in intervention group was significantly higher than that of the control group (22.5 μgmL-1 and 17.5 μgmL-1, respectively, P=0.007).With minimal inhibitory concentration (Cmin)>8 μgmL-1 serving as target, the rate of reaching the standard was both 22. 2% on day 2, 100. 0% and 72. 2% on day 4 in intervention group and control group, respectively (P=0.015). With minimal inhibitory concentration (Cmin) >32 μgmL-1 serving as target, the rate of reaching the standard was both 0 on day 2, 38. 9% and 5. 5% on day 4 in intervention group and control group, respectively (P=0.015). The clinical curative rate of the intervention group and control group was 83.3% and 72.2%, respectively (P=0.437), and the failure rate was 16.7% and 27.8%, respectively.Bacteria clearance rate was 88.9%and 55.5% in the intervention group and control group, respectively(P8μg?mL-1为靶目标,干预组和对照组在第2天达标率均为22.2%,在第4天分别为100.0%和72.2%(P=0.015).以Cmin>32μg?mL-1为靶目标,则干预组和对照组在第2天达标率均为0,在第4天分别为38.9%和5.5%(P=0.015).干预组和对照组临床治愈率分别为83.3%和72.2%,差异无统计学意义(P=0.437),失败率分别为16.7%,27.8%.干预组细菌清除率为88.9%,对照组为55.5%(P<0.05).结论 ICU患者基于TDM的美罗培南个体化给药有助于提高PK/PD达标率和抗感染疗效.
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