抗菌药物治疗MRSA感染的疗效、安全性及费用分析  

Efficacy,safety and cost analysis of antimicrobial agents in the treatment of methicillin-resistant staphylococcus aureus infection

作　　者：胡萨萨[1] 马瑛[1] 尤海生[1] 董亚琳[1] 王茂义[1] HU Sasa;MA Ying;YOU Haisheng;DONG Yalin;WANG Maoyi(Department of Pharmacy,the First Affiliated Hospital of Xi′an Jiaotong University,Xi′an 710061,China)

机构地区：[1]西安交通大学第一附属医院药学部,西安710061

出　　处：《西北药学杂志》2020年第4期595-598,共4页Northwest Pharmaceutical Journal

基　　金：陕西省重点研发计划项目(编号:2019SF-197);陕西省自然科学基础研究计划项目(编号:2014JM4101)。

摘　　要：目的评价万古霉素、替考拉宁及利奈唑胺治疗耐甲氧西林金黄色葡萄球菌(MRSA)感染的有效性、安全性及费用疗效比。方法回顾性收集使用万古霉素、替考拉宁或利奈唑胺的确诊或疑似MRSA感染病例资料,比较各组患者的临床疗效、不良反应发生率及费用疗效比。结果共纳入141例,万古霉素组(45例)、替考拉宁组(48例)及利奈唑胺组(48例)治疗MRSA感染的临床有效率分别为64.44%,66.67%和60.42%(P>0.05);3组用药前后的血清炎症因子(降钙素原及C反应蛋白)降低程度比较差异无统计学意义,但均呈下降趋势;3组的不良反应发生率分别为26.67%(肾损伤占17.78%),16.67%和31.25%(血小板下降占10.42%)(P>0.05);替考拉宁组的费用疗效比明显低于另外2组。结论 3组的临床有效率低可能与用药剂量偏低、负荷剂量不足以及合并感染等多种因素有关,需加大血药谷质量浓度的监测力度,以提高临床治疗有效率。Objective To evaluate the efficacy,safety and cost-effectiveness ratio of vancomycin,teicoplanin and linezolid in the treatment of methicillin-resistant staphylococcus aureus(MRSA) infection.Methods The data of confirmed or suspected MRSA infection patients who treated with the vancomycin,teicoplanin and linezolid were collected retrospectively.The clinical efficacy,adverse reaction rate and cost-effectiveness ratio of each group were compared.Results A total of 141 cases was included,of which vancomycin group(45 cases),teicoplanin group(48 cases) and linezolid group(48 cases) had clinical efficacy of 64.44%,66.67% and 60.42%,respectively(P>0.05).The levels of serum inflammatory factors(procalcitonin and C-reactive protein) before and after treatment were not statistically different,but all showed a downward trend.The incidence of adverse reactions in the 3 groups was 26.67%(kidney damage accounted for 17.78%),16.67% and 31.25%(platelet decline accounted for 10.42%)(P>0.05).The cost-effectiveness ratio of the teicoplanin group was obviously lower than the other 2 groups.Conclusion The lower clinical efficiency of the 3 groups may be related to various factors such as lower dosage,insufficient loading dose,and multiple infections.It is necessary to promote the therapeutic drug monitoring to improve the efficiency of clinical treatment.

关 键 词：万古霉素 替考拉宁 利奈唑胺 耐甲氧西林金黄色葡萄球菌 临床评价 

分 类 号：R969.3[医药卫生—药理学]