实用药物与临床
實用藥物與臨床
실용약물여림상
Practical Pharmacy and Clinical Remedies
2015年
10期
1189-1192
,共4页
张东%李晶%杨艺敏%董雪超
張東%李晶%楊藝敏%董雪超
장동%리정%양예민%동설초
替加环素%经验性抗感染治疗%多重耐药菌%预后
替加環素%經驗性抗感染治療%多重耐藥菌%預後
체가배소%경험성항감염치료%다중내약균%예후
Tigecycline%Empirical antibiotic treatment%Multidrug resistant bacteria%Prognosis
目的 观察替加环素对重症患者经验性抗感染治疗的效果,为临床合理使用替加环素防治多重耐药菌感染及改善患者预后提供依据. 方法 选择2013年7月至2014年12月在我院ICU给予替加环素治疗的重症患者30例,比较替加环素治疗前后患者的体温、白细胞( WBC)及降钙素原( PCT)等临床感染指标及临床预后和并发症的发生率的变化. 结果 患者应用替加环素的总疗程为8. 5(6 ~12) d,临床成功(感染症状和体征部分或完全改善) 21 例,临床失败(感染症状和体征无改善或恶化) 9 例,替加环素治疗28 d后的死亡率为20% (6/30),并发转氨酶升高2 例. 替加环素治疗临床成功患者用药前后 APACHEⅡ和 SOFA 评分分别为(16. 05±8. 18 vs. 8. 61±5. 50,P<0. 001)和(6. 76±5. 18 vs. 2. 67±2. 52,P <0. 001),WBC ( × 109/L)和 PCT (ng/mL)分别为(15. 46±5. 73 vs. 8. 81±3. 44,P<0. 001)和(4. 88±5. 73 vs. 0. 37±0. 35,P<0. 01),患者体温完全恢复正常时间为7(5~10) d. 结论 对可疑MDR病原菌感染的重症患者使用替加环素经验性治疗能够提高临床抗感染的成功率,进而可能改善重症患者的预后.
目的 觀察替加環素對重癥患者經驗性抗感染治療的效果,為臨床閤理使用替加環素防治多重耐藥菌感染及改善患者預後提供依據. 方法 選擇2013年7月至2014年12月在我院ICU給予替加環素治療的重癥患者30例,比較替加環素治療前後患者的體溫、白細胞( WBC)及降鈣素原( PCT)等臨床感染指標及臨床預後和併髮癥的髮生率的變化. 結果 患者應用替加環素的總療程為8. 5(6 ~12) d,臨床成功(感染癥狀和體徵部分或完全改善) 21 例,臨床失敗(感染癥狀和體徵無改善或噁化) 9 例,替加環素治療28 d後的死亡率為20% (6/30),併髮轉氨酶升高2 例. 替加環素治療臨床成功患者用藥前後 APACHEⅡ和 SOFA 評分分彆為(16. 05±8. 18 vs. 8. 61±5. 50,P<0. 001)和(6. 76±5. 18 vs. 2. 67±2. 52,P <0. 001),WBC ( × 109/L)和 PCT (ng/mL)分彆為(15. 46±5. 73 vs. 8. 81±3. 44,P<0. 001)和(4. 88±5. 73 vs. 0. 37±0. 35,P<0. 01),患者體溫完全恢複正常時間為7(5~10) d. 結論 對可疑MDR病原菌感染的重癥患者使用替加環素經驗性治療能夠提高臨床抗感染的成功率,進而可能改善重癥患者的預後.
목적 관찰체가배소대중증환자경험성항감염치료적효과,위림상합리사용체가배소방치다중내약균감염급개선환자예후제공의거. 방법 선택2013년7월지2014년12월재아원ICU급여체가배소치료적중증환자30례,비교체가배소치료전후환자적체온、백세포( WBC)급강개소원( PCT)등림상감염지표급림상예후화병발증적발생솔적변화. 결과 환자응용체가배소적총료정위8. 5(6 ~12) d,림상성공(감염증상화체정부분혹완전개선) 21 례,림상실패(감염증상화체정무개선혹악화) 9 례,체가배소치료28 d후적사망솔위20% (6/30),병발전안매승고2 례. 체가배소치료림상성공환자용약전후 APACHEⅡ화 SOFA 평분분별위(16. 05±8. 18 vs. 8. 61±5. 50,P<0. 001)화(6. 76±5. 18 vs. 2. 67±2. 52,P <0. 001),WBC ( × 109/L)화 PCT (ng/mL)분별위(15. 46±5. 73 vs. 8. 81±3. 44,P<0. 001)화(4. 88±5. 73 vs. 0. 37±0. 35,P<0. 01),환자체온완전회복정상시간위7(5~10) d. 결론 대가의MDR병원균감염적중증환자사용체가배소경험성치료능구제고림상항감염적성공솔,진이가능개선중증환자적예후.
Objective To observe the therapeutic effect of tigecycline on empirical antibiotic treatment of criti-tally ill patients,and provide the evidence for rational use of tigecycline in prophylaxis and treatment of multi-drug re-sistant bacteria infection and improving the prognosis of patients. Methods A total of 30 critially ill patients admitted to Intensive Care Unit ( ICU) of our hospital from July 2013 to December 2014 were treated with tigecycline. The changes of the temperature,white blood cells ( WBC) counts and procalcitonin ( PCT) value before and after treatment of tigecycline were compared,and the prognosis and the incidence of complications were observed. Results The course of tigecycline treatment were 8. 5 (6~12) d. There were 21 patients with clinically success (the infection symp-toms and signs improved partially or completely),9 patients with clinically failed ( the infection symptoms and signs had no improvement or deteriorated). The mortality at 28 d after treatment was 20% (6/30). Only 2 patients were complicated with elevated hepatic enzymes. The APACHE Ⅱ scores of patients with clinically success before and after treatment were 16. 05±8. 18 and 8. 61±5. 50 ( P <0. 001 ),and SOFA scores were 6. 76±5. 18 and 2. 67±2. 52 (P<0. 001) respectively,WBC ( × 109/L) were 15. 46±5. 73 and 8. 81±3. 44(P <0. 001),and PCT (ng/mL) were 4. 88±5. 73 and 0. 37±0. 35(P<0. 01) respectively. The time of temperature recovered to normal was 7 (5 ~10) d. Conclusion Empirically antibiotic treatment with tigecycline in the critically ill patients,who were suspected of infection with multidrug resistant bacteria,could promote the success rate of anti-infection therapy and then improve the prognosis.
