比阿培南在老年患者中的合理应用及疗效评价

比阿培南是新型1β-甲基碳青霉烯类抗生素,但说明书中并未明确老年患者如何用药。本文主要综述药物在老年人体内的代谢特点、比阿培南在老年患者体内的代谢动力学特征以及临床疗效和不良反应,为老年患者合理应用比阿培南提供依据。比阿培南在老年患者体内的代谢动力学参数如血浆药物浓度时间曲线、尿中原形累积排泄率及半衰期与年轻患者无明显差异,仅总清除率和肾脏清除率呈年龄相关性下降。因此,比阿培南应用于中、重度感染老年患者,在肾功能随年龄正常下降时无需调整给药剂量,而当肾功能严重衰竭(肌酐清除率<21.1 mL/min)时应酌情减量。

Rational medication and therapeutic evaluation of Biapenem in the elderly population

Biapenem is a comparatively new kind of 1β-methyl carbapenem antibiotic, of which the specification of drug application in the elderly is not yet fully discovered. This review is designed to summarize drug metabolism in elderly population. Furthermore, we sum up pharmacokinetic characteristics, clinical efficacy and adverse reactions of biapenem in the elderly. Pharmacokinetic studies of biapenem in the elderly found that its prototype accumulation in the plasma drug concentration-versus-time curve, urinary excretion rate, and half-life of the drug had no significance difference as compared to young people. Only the total body clearance and renal clearance rate showed an age-related decline. For older patients with severe infections, based on the normal renal function with senility, dosage adjustment of biapenem is not essential. Biapenem is recommended to reduce dosage in elderly with severe renal failure (Creatinine clearance rate <21.1 mL/min).