不同起始负荷剂量替考拉宁治疗革兰阳性菌下呼吸道感染的疗效与安全性评价

发布时间：2018-06-05 06:58

本文选题：替考拉宁 + 下呼吸道感染　；参考：《中华医院感染学杂志》2015年20期

【摘要】：目的评价替考拉宁在不同起始负荷剂量下治疗中重度革兰阳性菌下呼吸道感染的临床疗效和安全性。方法选取2011年6月-2013年12月的46例中重度医院获得性革兰阳性菌下呼吸道感染患者的临床资料进行探讨分析,根据替考拉宁治疗前3d起始负荷剂量的不同分为试验组起始负荷剂量800mg,每天2次,对照组起始负荷剂量400mg,每天2次,比较治疗前后患者的临床疗效、细菌学清除率及不良反应发生率。结果在替考拉宁治疗前,46例中重度医院获得性革兰阳性菌下呼吸道感染患者共分离出革兰阳性菌56株,其中耐甲氧西林金黄色葡萄球菌(MRSA)24株占42.86%,凝固酶阴性葡萄球菌15株占26.78%;治疗后,试验组和对照组患者总有效率分别为88.89%、71.43%,差异有统计学意义(P0.05);试验组及对照组患者细菌清除率分别为83.33%、67.68%,差异有统计学差异(P0.05);不良反应发生率试验组为11.11%,对照组为10.71%,差异无统计学意义,经对症处理后不良反应缓解。结论中重度医院获得性革兰阳性菌下呼吸道感染患者在使用替考拉宁时,较高的起始负荷剂量可显著提高临床疗效,以期快速达到有效的药物治疗浓度,且肾功能损害等不良反应未见明显增高,安全性良好。
[Abstract]:Objective to evaluate the efficacy and safety of teicoplanin in the treatment of moderate and severe lower respiratory tract infection with Gram-positive bacteria at different initial loading doses. Methods the clinical data of 46 patients with moderate and severe nosocomial Gram-positive bacteria lower respiratory tract infection from June 2011 to December 2013 were analyzed. According to the initial loading dose of teicoplanin three days before treatment, the patients in the trial group were divided into two groups: the initial load dose of 800 mg, twice a day, and the control group of 400 mg, twice a day. The clinical efficacy of the patients before and after treatment was compared. Bacteriological clearance rate and incidence of adverse reactions. Results A total of 56 strains of Gram-positive bacteria were isolated from 46 patients with moderate and severe nosocomial Gram-positive bacteria. Among them, 24 strains of methicillin-resistant Staphylococcus aureus and 15 strains of coagulase-negative Staphylococcus aureus accounted for 42.86% and 26.78%, respectively. The total effective rate of the patients in the test group and the control group was 88.89 and 71.43, respectively. The difference was statistically significant (P 0.05); the bacterial clearance rate of the patients in the test group and the control group was 83.33 and 67.68, respectively. The difference was statistically significant (P 0.05); the incidence of adverse reactions was 11.11 in the experimental group and 10.71 in the control group. The difference was not statistically significant. Adverse reactions were alleviated after symptomatic treatment. Conclusion when teicoplanin was used in patients with moderate and severe nosocomial Gram-positive bacteria lower respiratory tract infection, the higher initial loading dose could significantly improve the clinical efficacy and achieve a rapid and effective drug treatment concentration. The adverse reactions such as renal dysfunction were not significantly increased, and the safety was good.
【作者单位】：郑州大学第一附属医院呼吸与危重症一科;
【基金】：河南省卫生厅医学科技攻关基金资助项目(201401005)
【分类号】：R56

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