利奈唑胺与万古霉素治疗肠球菌血流感染疗效和安全性的真实世界研究  

A real-world study of the efficacy and safety of linezolid versus vancomycin in the treatment of Enterococcal bloodstream infections

作　　者：唐冰颖 伊茂礼[2] 高婷 霍雪臣[3] TANG Bingying;YI Maoli;GAO Ting;HUO Xuechen(Department of Pharmacy,Yantai Yuhuangding Hospital,Yantai 264000,Shandong Province,China;Department of Clinical Laboratory,Yantai Yuhuangding Hospital,Yantai 264000,Shandong Province,China;Department of Hepatobiliary Surgery,Yantai Yuhuangding Hospital,Yantai 264000,Shandong Province,China)

机构地区：[1]烟台毓璜顶医院药学部,山东烟台264000 [2]烟台毓璜顶医院检验科,山东烟台264000 [3]烟台毓璜顶医院肝胆外科,山东烟台264000

出　　处：《药物流行病学杂志》2024年第7期770-777,共8页Chinese Journal of Pharmacoepidemiology

基　　金：烟台市科技计划项目(2022YD043)。

摘　　要：目的比较利奈唑胺与万古霉素治疗肠球菌血流感染住院患者的有效性与安全性,为临床提供用药参考。方法回顾性收集烟台毓璜顶医院2019年6月—2023年6月99例肠球菌血流感染住院患者的临床资料,按使用药物不同分为利奈唑胺组与万古霉素组,采用倾向性评分匹配法控制混杂因素,比较2组的临床疗效、炎性因子水平与不良反应发生情况。结果倾向性评分匹配后,2组各纳入25例患者。2组患者的有效率、30 d死亡率、不良反应发生率,以及治疗后炎症因子水平等指标比较,差异均无统计学意义(P>0.05)。结论在肠球菌血流感染住院患者使用利奈唑胺或万古霉素的临床疗效与安全性基本一致。在万古霉素发生肾毒性及谷浓度未达标或超标考虑换药时,可优先考虑利奈唑胺。本研究受纳入样本量和信息收集限制,上述结论有待更多高质量研究予以验证。Objective To compare the efficacy and safety of linezolid and vancomycin in the treatment of hospitalized patients with Enterococcus bloodstream infection,to provide medication choices for clinical practice.Methods The clinical data of 99 inpatients with Enterococcus bloodstream infection in Yantai Yuhuangding Hospital from June 2019 to June 2023 were retrospectively collected,and the patients were divided into linezolid group and vancomycin group according to the drug used.confounding factors were controlled by propensity score matching method.The clinical efficacy,inflammatory factor levels,and adverse reactions of the two groups were compared.Results After using propensity score matching,25 patients were assigned to both linezolid group and vancomycin group.There was no significant difference in the effective rate,30-day mortality,incidence of adverse reactions and inflammatory factor levels between the two groups(P>0.05).Conclusion In the treatment of patients with Enterococcus bloodstream infection,the efficacy and safety of linezolid and vancomycin are the same.Linezolid can be a prioritized medicine when vancomycin causes nephrotoxicity and concentration does not meet the standard or exceeds the standard.Due to limitation of sample size and information collection,more high-quality studies are required to verify above conclusions.

关 键 词：血流感染 肠球菌 利奈唑胺 万古霉素 有效性 安全性 倾向性评分匹配 

分 类 号：R969[医药卫生—药理学]