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  

Efficacy and safety of different initial loading doses of teicoplanin in treatment of lower respiratory tract infections due to gram-positive bacteria

作　　者：杨睿[1] 鲁新华[1] 张国俊[1] 

机构地区：[1]郑州大学第一附属医院呼吸与危重症一科,河南郑州450052

出　　处：《中华医院感染学杂志》2015年第20期4673-4675,共3页Chinese Journal of Nosocomiology

基　　金：河南省卫生厅医学科技攻关基金资助项目(201401005)

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(P<0.05);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(P<0.05);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。OBJECTIVE To evaluate the clinical efficacy and safety of different initial loading doses of teicoplanin in treatment of severe lower respiratory tract infections caused by gram‐positive bacteria .METHODS From Jun 2011 to Dec 2013 ,a total of 46 patients with severe hospital‐acquired lower respiratory tract infections caused by gram‐positive bacteria were enrolled in the study ,and the clinical data of the participants were analyzed .The partici‐pants were grouped according to the initial loading dose of teicoplanin 3 days before the treatment ,the experimen‐tal group was treated with the initial loading dose of 800 mg ,twice a day ,while the control group was given the initial dose of 400 mg ,twice a day .The clinical efficacy ,bacteriological clearance rate ,and incidence of adverse reactions were observed and compared before and after the treatment .RESULTS Totally 56 strains of gram‐positive bacteria were isolated from the 46 patients with severe hospital‐acquired lower respiratory tract infections caused by gram‐positive bacteria before they were treated with teicoplanin ,including 24 （42 .86% ） strains of methicillin‐resistant Staphylococcus aureus and 15 （26 .78% ） strains of coagulase‐negative Staphylococcus .The total effec‐tive rate of treatment of the experimental group was 88 .89% ,the control group 71 .43% ,and there was signifi‐cant difference （P〈0 .05） .The clearance rate of bacteria was 83 .33% in the experimental group ,67 .68% in the control group ,and the difference was significant （P〈0 .05） .The incidence of adverse reactions was 11 .11% in the experimental group ,10 .71% in the control group ,there was no significant difference ,and the adverse reac‐tions remitted after symptomatic treatment .CONCLUSIONS The high initial loading dose of teicoplanin may remarkably improve the clinical efficacy in treatment of moderate and severe hospital‐acquired lower respiratory tract infections caused by gram‐positive bacteria so as to rapidly reach the effe

关 键 词：替考拉宁 下呼吸道感染 革兰阳性菌 

分 类 号：R978.1[医药卫生—药品]