Đánh giá kết quả điều trị rối loạn thái dương hàm dưới bằng máng nhai ổn định

Hinh 2b. pK/pD cua khang sinh meropenem d6i vai A.

bau m an nii

06i vdi khdng sinh Meropenem, a cdc gid tri MIC

= 8 pg/ml, cb th i duy tri duo’c 40% T (thdi gian ning

dd khdng sinh du’c^i dudng cong) > MIC (Hinh 2,

Phai) thdng qua tdi 3 phdc d l c6 th i c6

(1000mg/q8h/3hr/IV; 1000mg/q8h/3min/iV;

500mg/q6h/3min/IV). Nghien ciru cung cho thiy, tuy

ning <36 MICmem md cdc nhd l§m sdng c6 th i lya

chon phdc d l d ilu trj cho cdc nhiim khuln do

Acinetobacter baumannii. Ching han, d li vdi cdc

chung c6 MICMEm trong khoang 4 - 6 pg/ml, cb th i dp

dyng c6 th i dp dyng ca 6 phdc d i d ilu tri thdng

thudng (500mg/ q8h/ 3min/ IV; 500mg/ q8h/ 3hr/ IV;

500mg/ q6h/ 30min/ IV; 500mg/ q6h/ 3hr/ IV; 1000mg/

q8h/ 3min/ IV; 1000mg/ q8h/ 3hr/ IV) [4], Trong cdc ca

bfenh nhifem trung ndng, vdi cdc trudng hop MICmem

tu -8 -1 0 pg/ml, cdc nhd Idm sdng vdn cb the xem xfet

2 phdc d l 1000mg/q8h/3hr/IV vd

1000mg/q8h/3min/IV trong khi tim kilm cdc lifeu phdp

khdng sinh khde. D li vdi cdc trudng hap cd MICmem

> 32 pg/ml nhu trong nghifen cu’u ndy, mdc du cd

phdc d l cd th i duy tri khoang 5%T, nhung vdn se

th it bai trong vifec dua %T>40. D ilu ndy cd the cho

th iy 1 hifeu qua cao han cua Meropenem so vdi

Imipenem, trong d ilu tri nhiim khuin do

Acinetobacter baumannii.

k £ t LUAN

Trong m iu nghifen cu’u, lin luol han 62% vd 66%

cdc chung AB phdn Idp du’ac cd MIC cua

Meropenem vd Imipenem >8 pg/ml. Theo CLSI 2013,

gid tri ndy cd nghTa Id vi khuin dd khdng hodn todn

vdi Meropenem vd Imipenem

Trong cdc ca bfenh nhiim trung ndng do

Acinetobacter baumannii vdi MIC cua Imipenem vd

Meropenem tuang duang 8 pg/ml phdng xfet nghifem

vi sinh Idm sdng khuyln cdo su dung phdc d l dilu trj

thdng thudng cho ngudi Idn (1 ngdy/3 lin . cdch nhau

8 gid/1 g tifem tTnh mach trong 3 tilng =

1000mg/q8h/3hr/IV).

Cdc mUc MIC cua Imipenem vd Meropenem dudi

8, cd th i dp dung 5 trong 6 phdc d l d ilu trj cd th i

(500mg/q8h/3hr/IV; 500mg/q6h/30min/IV;

500mg/q6h/3hr/IV; 1000mg/q8h/3min/IV;

1000mg/q8h/3hr/IV).

Tu gid tri MICmem cd th i du dodn 79% gid trj cua

MICimp, theo phuang trinh: MICIMp = 3,92 +

0,9MICmem

TAI LIEU THAM KHAO

1. Do Van Dung (2007), Scientific research methods

and statistical analysis with ST AT A 8.0 software, the

Faculty of Public Health, University of Medicine and

Pharmacy, Ho Chi Minh City.

2. Van P. H. and MIDAS Group Research. The

multicenter study on the resistance to Imipenem and

Meropenem of the Non-fastidious Gram (-) rods - The

results from 16 hospitals in Viet Nam. Medical Journal of

Ho Chi Minh City. 2010. Issue 14 (2): 1 - 7.

3. Tran Vdn Ngoc. Thyc trang d l khdng khdng sinh

trong vifem phoi tai Vifet Nam vd hirdng d in dilu trj ban

dau. CME ve Be khing khing sinh - Thyc trang v i giSi

phip, ngay 29/9/2013. DH Y duoc Tp. HCM.

4. Lee LS, Kinzig-Schippers M, Nafziger AN, Ma L,

.Sorgel F, Jones RN, Drusano GL and Berlino Jr JS

Comparison of 30-min and 3-h infusion regimens for

imipenem/cilastin and for meropenem evaluated by

Monte Carlo simulation. Diagnostic Microbiology and

Infectious Disease. 2010. 68: 251 - 258.

5. Nguyen ST Tuan va cdng sy. Nghien cuu MIC

Imipenem, Meropenem va mo hinh khang khdng sinh

cua Acinetobacter baumannii tai bfenh vifen Da khoa

Thong Nhat Dong Nai. Tap chi Y hoc Thi/c hanh. 2013,

submitted.

6. Pham Hung Vdn va Pham Thdi Binh Khdng sinh

- D l khang khang sinh: Ky thudt khang sinh d l - Cdc

van de ca ban thu’dng gap. Nha xuat ban Y hpc 2013.

DANH GIA KET QUA DIEU TR| ROI LOAN THAI DUDNG HAM D ltil

B&NG MANG NHAI ON DINH

NGUYIN THI THU PHUONG, NGUY&N MANH THANH, VO TRUONG NHU NGQC -

Vi$n DT R in g H im M ft

BUI MY HANH - B§ mdn Sinh ly, Trudng DH Y H i NQi

TOM TAT th ii durong him. Dinh g ii cic chi s6 VAS (Visual

Muc ti§u nghien ciru: Dinh g ii hieu qui cua Analog Scale), bien cJ<? h i ng$m mi$ng. tiing k6u

ming nhai 6n dinh tren benh nhin roi loan thii duong khdp, l$ch dudng h i ng$m mt$ng, EAI

him. Doi tuqmg v i phuong p h ip nghien cuu: (Electrography Activity Index) dupe ghi nh$n trudc v i

Nghien ciru duoc thiit k i theo phuong phip md ti sau deo ming nhai 6n djnh. K it q u i: Sau thdi gian

d t ngang tren 22 b$nh nhin c6 chin doin r6i loan deo ming 1 thing v i 3 thing cic tn$u chimg lim

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MIC (mcB'mL)

66 Y HOC THUC HANH (902) - S6 1/2014