头孢哌酮钠舒巴坦钠与哌拉西林钠/他唑巴坦钠治疗复杂性尿路感染的安全性与有效性  

Efficacy and safety of cefoperazone-sulbactam and piperacillin-tazobactam in treatment of complicated urinary tract infection

作　　者：姬波 李树蕤 关月 曹珊珊 陈炳富 张维 王婧雯 JI Bo;LI Shu-rui;GUAN Yue;CAO Shan-shan;CHEN Bing-fu;ZHANG Wei;WANG Jing-wen(The First Affiliated Hospital of Air Force Military Medical University,Xi'an,Shaanzi 710032,China;不详)

机构地区：[1]空军军医大学第一附属医院药剂科,陕西西安710032 [2]延安大学附属医院临床药学科,陕西延安716000 [3]牛津大学医学科学部药理学部门,英国牛津OX13QT [4]天津中医药大学中药学院,天津301600

出　　处：《中华医院感染学杂志》2024年第6期841-846,共6页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金面上基金资助项目(72074218)。

摘　　要：目的 探究头孢哌酮钠舒巴坦钠和哌拉西林钠/他唑巴坦钠治疗复杂性尿路感染(cUTIs)的安全性与有效性。方法 选择空军军医大学第一附属医院在2019年1月—2021年11月收治的成人cUTIs患者213例为研究对象,其中103例患者给予头孢哌酮钠舒巴坦钠,110例患者给予哌拉西林钠/他唑巴坦钠。判定标准为抗菌药物治疗后的临床治愈率、微生物清除率、抗菌药物总治疗时间、有效抗菌药物治疗时间、住院时间、尿路感染复发率、再住院率、全因病死率。结果 两组基线特征无统计学差异,引起cUTIs的病原菌分布相似。安全性方面,除了尿路感染复发率,哌拉西林钠/他唑巴坦钠组抗菌药物治疗总持续时间、有效抗菌药物治疗持续时间和住院天数均高于头孢哌酮钠舒巴坦钠组(P<0.05)。全因病死率两组无统计学差异。有效性方面,头孢哌酮钠舒巴坦钠组的临床治愈率和微生物清除率均高于哌拉西林钠/他唑巴坦钠组(P<0.05)。在不良事件发生率方面,头孢哌酮钠舒巴坦钠组稍高(P<0.05)。结论 采用头孢哌酮钠舒巴坦钠和哌拉西林钠/他唑巴坦钠治疗产ESBL和氨基-R肠杆菌科细菌引起的cUTIs具有安全性和有效性。OBJECTIVE To explore the safety and efficacy of cefoperazone-sulbactam and piperacillin-tazobactam in treatment of complicated urinary tract infections(cUTIs).METHODS A total of 213 adult patients with cUTIs who were treated in the First Affiliated Hospital of Air Force Military Medical University from Jan 2019 to Nov 2021 were recruited as the study subjects,103 of whom were treated with cefoperazone-sulbactam,and 110 were treated with piperacillin-tazobactam.The safety and efficacy were judged based on the clinical cure rate,eradica-tion rate of microorganisms,total treatment time of antibiotics,effective treatment time of antibiotics,length of hospital stay,recurrence rate of urinary tract infection,rehospitalization rate and all-cause mortality rate after the antibiotic therapies.RESULTS There were no significant differences in the baseline characteristics between the two groups;the pathogens causing the cUTIs were basically same.In terms of the safety,the recurrence rate of urina-ry tract infection of the piperacillin-tazobactam group was lower than that of the cefoperazone-sulbactam group,while the total duration of antibiotic treatment,effective treatment duration of antibiotic and length of hospital stay were longer in the piperacillin-tazobactam group than in the cefoperazone-sulbactam group(P<0.05).There was no significant difference in the all-cause mortality rate between the two group.In terms of efficacy,the clinical cure rate and eradication rate of microorganisms were higher in the cefoperazone-sulbactam group than in the pip-eracillin-tazobactam group(P<0.05).The incidence of adverse events of the cefoperazone-sulbactam group was higher than that of the piperacillin-tazobactam group(P<0.05).CONCLUSION Cefoperazone-sulbactam and pip-eracillin-tazobactam show high safety and efficacy in treatment of cUTIs induced by ESBL-producing and amin-oglycosides-resistant Enterobacteriaceae.

关 键 词：复杂性尿路感染 病原菌 产超广谱β-内酰胺酶 抗菌药物治疗 头孢哌酮钠舒巴坦钠 哌拉西林钠/他唑巴坦钠 安全性与有效性 

分 类 号：R691.3[医药卫生—泌尿科学]