Effects of biapenem on the blood concentration of sodium valproate in patients with severe infections： a retrospective study

CHOU Xiaohua; ZHANG Qian; LIU Zhidong; JIANG Daoli

doi:10.6039/j.issn.1001-0408.2025.24.11

您当前的位置：

首页 >

文章列表页 >

Effects of biapenem on the blood concentration of sodium valproate in patients with severe infections： a retrospective study

更新时间：2025-12-26

- Effects of biapenem on the blood concentration of sodium valproate in patients with severe infections： a retrospective study
- ZHONGGUO YAOFANG Vol. 36, Issue 24, Pages: 3079-3083(2025)
- 作者机构：
  
  徐州医科大学附属医院药学部，江苏徐州　221004
- 作者简介：
- 基金信息：
- DOI：10.6039/j.issn.1001-0408.2025.24.11
  CLC： R978.1;R971+.6
- Received：21 July 2025，
  
  Revised：2025-12-01，
  
  Accepted：01 December 2025，
  
  Published：30 December 2025
- 稿件说明：
移动端阅览
丑晓华,张倩,刘志东,等.比阿培南对重症感染患者丙戊酸钠血药浓度影响的回顾性研究 ^Δ[J].中国药房,2025,36(24):3079-3083.

CHOU Xiaohua,ZHANG Qian,LIU Zhidong,et al.Effects of biapenem on the blood concentration of sodium valproate in patients with severe infections： a retrospective study[J].ZHONGGUO YAOFANG,2025,36(24):3079-3083.
丑晓华,张倩,刘志东,等.比阿培南对重症感染患者丙戊酸钠血药浓度影响的回顾性研究 ^Δ[J].中国药房,2025,36(24):3079-3083. DOI： 10.6039/j.issn.1001-0408.2025.24.11.

CHOU Xiaohua,ZHANG Qian,LIU Zhidong,et al.Effects of biapenem on the blood concentration of sodium valproate in patients with severe infections： a retrospective study[J].ZHONGGUO YAOFANG,2025,36(24):3079-3083. DOI： 10.6039/j.issn.1001-0408.2025.24.11.

摘要

目的

分析比阿培南对重症感染患者丙戊酸钠（VPA）血药浓度的影响。

方法

回顾性收集2021年1月－2024年5月我院收治的使用比阿培南治疗重症感染的同时或先后使用了VPA预防或治疗癫痫的患者资料。分析联用比阿培南、用药顺序、联用天数、比阿培南剂量及停用时间对VPA血药浓度的影响。

结果

共纳入70例患者的117个VPA血药浓度结果。单用VPA时，先用比阿培南与后用比阿培南患者的VPA稳态血药浓度比较无显著差异（

＞0.05）。比阿培南联用1～3 d者与未联用者的VPA稳态血药浓度比较无显著差异（

＞0.05）；但未联用比阿培南者的VPA稳态血药浓度显著高于联合用药4～7 d者和＞7 d者（

＜0.001）。随着联用时间的延长，VPA血药浓度逐渐降低（

＜0.001），但联合用药＞7 d者与联合用药4～7 d者比较无显著差异（

＞0.05）。联合用药1～3 d后比阿培南不同停用时间者之间的VPA血药浓度比较均无显著差异（

＞0.05）；但联合用药＞3 d者的VPA血药浓度较未联用者、联合用药＞3 d停用比阿培南4～7 d或停用＞7 d者均显著降低（

＜0.001）。比阿培南日剂量＞1.0 g者与日剂量＜1.0 g者的VPA血药浓度比较无显著差异（

＞0.05）。

结论

联用比阿培南1～3 d对VPA血药浓度的影响较小，联合用药＞3 d的患者的VPA血药浓度可在停用比阿培南4～7 d后恢复。

Abstract

OBJECTIVE

To analyze the effects of biapenem on the blood concentration of sodium valproate （VPA） in patients with severe infections.

METHODS

A retrospective collection of patient data was conducted， encompassing individuals admitted to our hospital from January 2021 to May 2024 who were treated with biapenem for severe infections and concurrently or sequentially administered VPA for the prevention or treatment of epilepsy. The effects of various factors on the blood concentration of VPA， including the combination of biapenem， the sequence of biapenem administration， the number of days of biapenem combination， the dosage of biapenem， and the time after biapenem discontinuation.

RESULTS

A total of 70 patients with 117 VPA blood concentration results were included in this study. When VPA was used alone， no statistically significant difference was observed in the steady-state blood concentrations of VPA between patients who received biapenem first and those who received it later （

＞0.05）. There was no statistically significant difference between the steady-state concentration of VPA in patients who received biapenem in combination for 1 to 3 days and those who did not receive the combination therapy （

＞0.05）. The steady-state concentration of VPA in patients not receiving biapenem combination therapy was significantly higher than that of the patients who received combination therapy for 4 to 7 days and more than 7 days （

＜0.001）. With the prolonged duration of combination therapy， the blood concentration of VPA gradually decreased （

＜0.001）. However， no statistically significant difference was observed between the group receiving combination therapy for more than 7 days and the group receiving it for 4 to 7 days （

＞0.05）. After 1 to 3 days of combination therapy， no statistically significant differences in VPA blood concentrations were observed among patients with different discontinuation times of biapenem （

＞0.05）. The blood concentration of VPA in patients who received combination therapy for more than 3 days was significantly lower than those who discontinued biapenem 4 to 7 days or more than 7 days after more than 3 days of combination therapy（

＜0.001）. There was no statistically significant difference in VPA blood co

ncentrations between patients receiving a daily biapenem dose ＞1.0 g and those receiving a daily dose ＜1.0 g （

＞0.05）.

CONCLUSIONS

The concomitant administration of biapenem for 1-3 days has a minimal impact on the blood concentration of VPA. In patients receiving combination therapy for longer than 3 days， VPA blood concentrations return to baseline levels within 4-7 days after biapenem discontinuation.

关键词

Keywords

references

丁雁鸣，柳丽丽，刘艳萍，等 . 基于FAERS数据库的丙戊酸不良事件信号挖掘 [J ] . 中国药房， 2023 ， 34 （ 23 ）： 2906 - 2909 .

丁靖，蒙卓成，张燕，等 . 2019—2021年2 992例次丙戊酸治疗药物监测结果的回顾性分析 [J ] . 中国全科医学， 2023 ， 26 （ 23 ）： 2923 - 2929 .

顾澜婷，王雨萍，陆韵竹，等 . 基因多态性对丙戊酸钠及代谢物血药浓度的影响及其与不良反应的相关性研究 [J ] . 药学与临床研究， 2023 ， 31 （ 5 ）： 396 - 400，424 .

王钰莹，于建海，赵丽平，等 . 三种碳青霉烯类药物对肝功能不全的重症感染合并癫痫患者丙戊酸钠血药浓度的影响及解决策略 [J ] . 中国全科医学， 2021 ， 24 （增刊1 ）： 52 - 54 .

CHAI P Y ， CHANG C T ， CHEN Y H ， et al . Effect of drug interactions between carbapenems and valproate on serum valproate concentration：a systematic review and meta-analysis [J ] . Expert Opin Drug Saf ， 2021 ， 20 （ 2 ）： 215 - 223 .

GU C P ， ZHANG Y F ， YUAN F M ， et al . Effect of a declined plasma concentration of valproic acid induced by meropenem on the antiepileptic efficacy of valproic acid [J ] . J Clin Lab Anal ， 2024 ， 38 （ 8 ）： e25025 .

《抗菌药物临床应用指导原则》修订工作组 . 抗菌药物临床应用指导原则：2015年版 [M ] . 北京：人民卫生出版社， 2015 ： 42 .

HUANG C R ， LIN C H ， HSIAO S C ， et al . Drug interaction between valproic acid and carbapenems in patients with epileptic seizures [J ] . Kaohsiung J Med Sci ， 2017 ， 33 （ 3 ）： 130 - 136 .

CHEN I L ， LEE C H ， HSIAO S C ， et al . Interactions between carbapenems and valproic acid among the patients in the intensive care units [J ] . J Crit Care ， 2021 ， 62 ： 151 - 156 .

赵华昌，黄攀云，尹学东 . 头孢曲松钠与比阿培南治疗重症肺炎临床效果对比观察 [J ] . 山东医药， 2023 ， 63 （ 25 ）： 64 - 66 .

朱愿超，邹琪，胡欣 . 比阿培南治疗高龄老年患者呼吸系统感染的分析 [J ] . 中华老年医学杂志， 2022 ， 41 （ 12 ）： 1489 - 1493 .

唐莲，庄智伟，赵富丽，等 . 比阿培南与美罗培南对丙戊酸血药浓度影响的比较研究 [J ] . 药物不良反应杂志， 2015 ， 17 （ 2 ）： 126 - 129 .

张华君，席加喜，叶冬梅，等 . 3种碳青霉烯类药物对重症感染合并癫痫患者丙戊酸钠血药浓度影响及其与肝肾功能相关性 [J ] . 中国医院药学杂志， 2019 ， 39 （ 8 ）： 857 - 861 .

WEN Z P ， FAN S S ， DU C ， et al . Drug-drug interaction between valproic acid and meropenem：a retrospective analysis of electronic medical records from neurosurgery inpatients [J ] . J Clin Pharm Ther ， 2017 ， 42 （ 2 ）： 221 - 227 .

WU C C ， PAI T Y ， HSIAO F Y ， et al . The effect of dif-ferent carbapenem antibiotics（ertapenem，imipenem/cilastatin，and meropenem）on serum valproic acid concentrations [J ] . Ther Drug Monit ， 2016 ， 38 （ 5 ）： 587 - 592 .

丑晓华，刘文，王来成 . 三种碳青霉烯类抗菌药物对丙戊酸钠血药浓度影响分析 [J ] . 中国处方药， 2018 ， 16 （ 9 ）： 6 - 8 .

KOECK J A ， HILGARTH H ， VON AMELN-MAYERHOFER A ， et al . Clinically relevant interactions with anti-infectives on intensive care units：a multicenter Delphi study [J ] . Antibiotics（Basel）， 2021 ， 10 （ 11 ）： 1330 .

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Determination method of clopidogrel and its metabolites in rat plasma and its pharmacokinetic study

Study on pharmacokinetic characteristics of ciprofol in pregnant and fetal rats

Establishment of a method for detecting propofol concentration in plasma and its application in patients with lymphedema

Research progress in therapy drug monitoring of levetiracetam

RP-HPLC-荧光法测定NM394 血药浓度及回归方程的选择

Related Author

YI Huan

MIAO Lan

REN Changying

LIN Li

SUN Mingqian

PENG Qing

ZHANG Ying

LIU Jianxun

Related Institution

Beijing Key Laboratory of Pharmacology of Chinese Materia Medica/Institute of Basic Medical Sciences of Xiyuan Hospital， China Academy of Chinese Medical Sciences

Dept. of Pharmacy， the Second Hospital of Hebei Medical University

School of Pharmacy， Hebei Medical University

Dept. of Pharmacy， Beijing Shijitan Hospital Affiliated to Capital Medical Hospital

Dept. of Anesthesiology， Beijing Shijitan Hospital Affiliated to Capital Medical Hospital

⁰