title: Pharmacokinetic-pharmacodynamic profiling of four antimicrobials against gram-negative bacteria collected from Shenyang, China.
abstract: BACKGROUND
  To examine common antimicrobial regimens used in eradicating certain nosocomial gram-negative pathogens and determine which ones are likely to be the most suitable as empirical choices in Shenyang, China.
  
  
  METHODS
  A 5000-subject Monte Carlo simulation was conducted to determine the cumulative fraction of response (CFR) for meropenem, imipenem, cefepime, piperacillin/tazobactam and levofloxacin against Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Acinetobacter baumannii and Pseudomonas aeruginosa collected in 2006 and 2007 from Shenyang.
  
  
  RESULTS
  Meropenem and imipenem had the highest CFRs against the Enterobacteriaceae (97%-100%), followed by cefepime. No antibiotic simulated regimen achieved optimal CFR against P. aeruginosa and A. baumannii. Piperacillin/tazobactam dosed at 4.5 g q8h achieved the lowest CFR against all bacteria.
  
  
  CONCLUSIONS
  This study suggests that the carbapenems provide the greatest likelihood of clinical success for the Enterobacteriaceae, and combination therapy might be needed when choosing empirical therapy, especially when A. baumannii or P. aeruginosa are suspected.
authors.affiliation: Department of Laboratory Medicine, The First Hospital of China Medical University, Shenyang, 110001, China.
authors.forename: Yun Zhuo
authors.initials: YZ
authors.lastname: Chu
authors.forename: Su Fei
authors.initials: SF
authors.lastname: Tian
authors.forename: Bai Yi
authors.initials: BY
authors.lastname: Chen
authors.forename: Hua
authors.initials: H
authors.lastname: Nian
authors.forename: Hong
authors.initials: H
authors.lastname: Shang
authors.forename: Guo Quan
authors.initials: GQ
authors.lastname: Sun
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000493:pharmacokinetics* / Q000494:pharmacology*; D002681:China; D003428:Cross Infection / Q000188:drug therapy* / Q000382:microbiology; D006090:Gram-Negative Bacteria / Q000187:drug effects* / Q000302:isolation & purification; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D047090:beta-Lactams / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000494:pharmacology
chemical_list: D000900:Anti-Bacterial Agents; D047090:beta-Lactams