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目的 制定某院β内酰胺类在铜绿假单胞菌(PA)血流感染中的治疗方案.方法 收集某院2015年至2016年血培养中铜绿假单胞菌共64株,测定β内酰胺类(哌拉西林/他唑巴坦,头孢他啶,头孢吡肟,亚胺培南,美罗培南)对铜绿假单胞菌的最低抑菌浓度(MIC).用蒙特卡洛模拟计算多种治疗方案的达标率(PTA)和累积反应分数(CFR).结果 经验治疗时,哌拉西林/他唑巴坦4.5 g(q6 h),头孢他啶2 g(q8 h),头孢Ⅱ比肟2 g(q8h),亚胺培南1g(q6h),美罗培南1 g(q8 h,q6h),共6种方案的CFR值＞90％;目标治疗时,当MIC≥16μg·mL-1时,模拟的所有方案达标概率值均＜90％.结论铜绿假单胞菌血流感染经验治疗时可选哌拉西林/他唑巴坦4.5 g(q6 h),头孢他啶2 g(q8h),头孢吡肟2 g(q8 h),亚胺培南1 g(q6 h),美罗培南1g(q8 h,q6h);目标治疗当MIC≥16 μg·nL-1时需要联合用药.“,”Objective To develop the regimens of β lactam antibiotics against bloodstream infection caused by Pseudomonas aeruginosa (PA).Methods A total of 64 strains of PA cultured by blood from 2015 to 2016,the minimum inhibitory concentration (MIC) of piperacillin/tazobactam (TZP),ceftazidine (CAZ),cefepime (FEP),imipenem (IPM),meropenem (MEM) against PA were determined,probability of target attainment (PTA) and cumulative fraction of response (CFR) were calculated by monte carlo simulation.Results CFRs of TZP 4.5 g (q6 h),CAZ 2 g(q8 h),FEP2 g(q8 h),IPM 1 g(q6 h) and MEM 1 g (q8 h,q6 h) were ＞ 90％ at experiential therapy,when MIC ≥ 16 μg· mL-1 at target therapy,PTA of all regimens ＜90％.Conclusion when the patient was PA bloodstream infection,we suggest TZP 4.5 g (q6 h),CAZ2 g(q8 h),FEP2 g(q8 h),IPM 1 g(q6 h) and MEM 1 g (q8 h,q6 h) regimens at experiential therapy,and combined with other antibiotics at target therapy when MIC ≥ 16 μg · mL-1.