替考拉宁治疗肺部感染38例的临床观察  

Teicoplanin in Treatment of Patients with Gram-positive coccus Pulmonary Infections:A Clinical Study

作　　者：刘升明[1] 黄志宏[1] 吴义[1] 马洪明[1] 陈丽[1] 

机构地区：[1]暨南大学附属第一医院呼吸科,广东广州510632

出　　处：《中华医院感染学杂志》2010年第15期2299-2300,共2页Chinese Journal of Nosocomiology

摘　　要：目的观察国产替考拉宁治疗肺部感染的疗效和安全性。方法对2008年5月-2009年4月住院的肺部感染患者38例,应用浙江医药股份有限公司生产的替考拉宁治疗4～22 d,观察其临床疗效、细菌清除率及不良反应发生率。结果 22例(57.9%)患者分离到革兰阳性球菌,其中耐甲氧西林金黄色葡萄球菌(MRSA)占59.1%,耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)占27.3%,屎肠球菌占13.6%;所有菌株均对替考拉宁敏感;临床总有效率为86.8%,细菌学清除率(按例计)为81.8%;对16例痰细菌学阴性患者经验性应用替考拉宁治疗,有效率为75.0%,而目标性治疗的有效率为95.4%,两者比较差异无统计学意义;仅1例患者出现轻微的皮肤瘙痒,不良反应发生率为2.6%。结论国产替考拉宁治疗革兰阳性球菌所致肺部感染疗效好,安全性高,可作为革兰阳性球菌,特别是MRSA、MRCNS所致肺部感染的经验治疗和目标治疗。OBJECTIVE To evaluate the efficacy and safety of teicoplanin（TEC,Zhejiang Medicine Co.Ltd.Xinchang Pharmaceutical Factory） in the treatment of patients with Gram positive（G＋） coccus pulmonary infections.METHODS Data of 38 cases of inpatients with pulmonary infections treated with teicoplanin in the First Affiliated Hospital of Jinan University from May 2008 to Apr 2009 were analyzed retrospectively,including time of therapy,therapeutic effectiveness and adverse effects.RESULTS G＋ cocci were isolated from 22 patients（57.9%）.Among them meticillin-resistant Staphylococcus aureus（MRSA） accounted for 59.1%,meticillin-resistant coagulase-negative Staphylococcus（MRCNS） for 27.3% and Enterococcus faecium for 13.6%.The TEC susceptibility test for the strains in 22 patients showed that all of the Staphylococci and Enterococci were susceptible.The total clinical effectiveness was 86.8%.Bacteriologic clearance rate was 81.8%.Sixteen patients with negative culture result were empirically treated with TEC and had 75.0% of clinical effectiveness.The effectiveness of target treatment was 95.4%.There was no significant difference between empirical treatment and target treatment.The adverse effects accounted for 2.6%（itch of skin in 1 patient）.CONCLUSIONS Teicoplanin is a very effective antibiotic for G＋ coccus pulmonary infections and safe for patients.In G＋ coccus pulmonary infections,especially suspected or confirmed MRSA or MRCNSinfections,TEC may be a choice for initial empirical and target treatment.

关 键 词：替考拉宁 革兰阳性球菌 治疗 

分 类 号：R978.1[医药卫生—药品]