高维持剂量替考拉宁治疗耐甲氧西林金黄色葡萄球菌肺部感染的疗效和安全性评价  

Efficacy and safety of high maintenance dose of teicoplanin in treatment of methicillin-resistant Staphylococcus aureus pulmonary infection

作　　者：郭晓斌[1] 冯可青[1] 赵丽敏[1] 程东军[1] 况红艳[1] 杨珍[1] 王小丽[1] 王学林 

机构地区：[1]河南省人民医院呼吸与危重症医学科,河南郑州450000

出　　处：《中华医院感染学杂志》2018年第4期481-484,共4页Chinese Journal of Nosocomiology

基　　金：河南省科技厅基金资助项目(82102310026)

摘　　要：目的分析和评价高维持剂量替考拉宁治疗耐甲氧西林金黄色葡萄球菌(MRSA)肺部感染的疗效和安全性,为临床抗感染治疗提供客观依据。方法选取2015年1月-2016年12月的96例MRSA肺部感染患者作为研究对象,分为试验组和对照组,每组各48例,对照组患者给予常规维持剂量替考拉宁(400mg/d)进行治疗,试验组患者给予高维持剂量替考拉宁(600mg/d)进行治疗,对两组患者的疗效指标、替考拉宁血药谷浓度(Cmin)进行观察和比较;对两组患者的病原菌清除效果、临床疗效及治疗期间的不良反应进行观察。结果试验组患者的疗效指标均优于对照组(P<0.001),替考拉宁Cmin高于对照组(P<0.001);试验组患者的病原菌清除效果优于对照组(P<0.001);两组患者不良反应差异无统计学意义。结论针对MRSA肺部感染患者应用高维持剂量替考拉宁方案进行治疗,能够提高治疗效果、加速临床症状的缓解、提升病原菌清除率、保持较高的血药浓度,且不会增加治疗的不良反应,具有较高的安全性。OBJECTIVE To evaluate the efficacy and safety of high maintenance dose of teicoplanin in treatment of methicillin-resistant Staphylococcus aureus（MRSA）pulmonary infection so as to provide objective basis for clinical treatment of the infection.METHODS A total of 96 patients with MRSA pulmonary infection who were treated in the hospital from Jan 2015 to Dec 2016 were recruited as the study objects and divided into the experimental group and the control group,with 48 cases in each group.The control group was given the routine maintenance dose of teicoplanin（400 mg/d）,while the experimental group was treated with high maintenance dose of teicoplanin（600 mg/d）.The curative effect indexes and trough plasma concentration（Cmin）of teicoplanin were observed and compared between the two groups of patients;the clearance effect of pathogens,clinical therapeutic effect and adverse reactions during the treatment were observed.RESULTS The curative effect indexes of the experimental group were better than those of the control group（P〈0.001）,and the Cmin of teicoplanin of the experimental group was higher than that of the control group（P〈0.001）.The clearance effect of pathogens of the experimental group was better than that of the control group（P〈0.001）.There were no significant differences in the adverse reactions between the two groups of patients.CONCLUSION The high maintenance dose of teicoplanin may boost the curative effect of the patients with MRSA pulmonary infection,accelerate the recovery of clinical symptoms,raise the clearance rate of pathogens and maintain high plasma concentration without increasing the incidence of adverse reactions,with the safety high.

关 键 词：高维持剂量 替考拉宁 耐甲氧西林金黄色葡萄球菌 肺部感染 疗效分析 安全性评价 

分 类 号：R563.1[医药卫生—呼吸系统]