不同维持剂量替考拉宁治疗MRSA感染医院获得性肺炎患者的临床疗效研究

Clinical efficacy of the different maintenance doses of teicoplaninin the treatment of the patients with hospital acquired pneumonia

  • 摘要: 目的 采用不同维持剂量替考拉宁治疗耐甲氧西林金黄色葡萄球菌医院获得性肺炎,以观察替考拉宁高维持剂量治疗的临床疗效及安全性。方法 选取2013年1月-2015年12月87例耐甲氧西林金黄色葡萄球菌医院获得性肺炎患者随机分组,治疗组44例、对照组43例,两组患者均给予化痰、扩张气道、营养支持等常规治疗,对照组给予替考拉宁(0.2 g/瓶,商品名加立信,浙江医药股份有限公司)每12 h 1次静脉给药400 mg,给药3次后予替考拉宁400 mg每日1次维持治疗,治疗组患者首日同样给予替考拉宁每12 h 1次静脉给药400 mg,给药3次后予替考拉宁600 mg,每日1次维持治疗,两组疗程10~14 d,观察两组患者症状缓解情况、临床疗效及细菌清除率,比较替考拉宁两种不同维持剂量治疗的疗效与安全性。结果 治疗组患者体温、胸闷、气促及咳嗽咳痰症状缓解所需时间均较对照组短;治疗组总有效率为86.36%,明显高于对照组69.77%,差异有统计学意义(u=2.2565, P<0.05);治疗组细菌清除率为88.63%,更优于对照组65.12%,差异有统计学意义(u=2.5898, P<0.05);另外,治疗组替考拉宁谷浓度为(21.84±5.37)mg·L-1,高于对照组谷浓度(12.65±4.93)mg·L-1,两组比较有统计学差异(t=8.3099,P<0.05)。结论 替考拉宁高维持剂量治疗耐甲氧西林金黄色葡萄球菌医院获得性肺炎疗效确切、安全可行,值得临床推荐。

     

    Abstract: OBJECTIVE Using the different maintenance doses of the teicoplanin to treat the hospital acquired pneumonia infected with the methicillin-resistant Staphylococcus aureus,in order to investigate the efficacy and security of the high teicoplanin maintenance dose.METHODS A total of 87 patients with the methicillin-resistant S.aureus hospital acquired pneumonia were selected from Jan.2013 to Dec.2015,and randomly divided into two groups:treatment group(44cases)and control group(43cases).The two groups were all given the conventional treatment of expanding airway,eliminating sputum and nutritional support,etc.On the basis of conventional treatment,the control group was given the teicoplanin 400 mg drip q12 hon the first day,and after three times in their stead,the patients were given 400 mg once daily maintenance treatment.Then,the treatment group on the first day was also given the teicoplanin 400 mg drip q12 h,but after three times in their stead,the maintenance treatment dose was600 mg once daily.The courses of treatment were 10 to 14days.The symptoms in the situation,the curative effect and the bacterial clearance rate were observed,in order to compare the efficacy and safety of the teicoplanin with two different maintenance doses.RESULTS The time needed to improve the clinical symptoms of treatment group was shorter than that of control group.The total effective rate of treatment group was 86.36%,which was significantly higher than that of control group(69.77%)(u=2.2565,P<0.05).Total bacterial clearance rate of treatment group was 88.63%,and it was significantly better than that of control group(65.12%)(u=2.5898,P<0.05).Bssides,the valley concentration of teicoplanin of treatment group was(21.84±5.37)mg·L-1,which was significantly higher than that of control group of(12.65±4.93)mg·L-1(t=8.3099,P <0.05).CONCLUSION The high teicoplanin maintenance dose in the treatment of the methicillin-resistant S.aureus hospital-acquired pneumonia is effective,safe and feasible,and is worth clinical recommendations.

     

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