目的：观察替加环素联合异帕米星治疗多重耐药鲍曼不动杆菌肺炎的临床治疗效果。方法采用回顾性分析方法对2012年1月～2014年1月2家大型综合性医院呼吸科和重症加强护理病房（Intensive Care Unit，ICU）确诊的属于院内获得性肺炎的多...目的：观察替加环素联合异帕米星治疗多重耐药鲍曼不动杆菌肺炎的临床治疗效果。方法采用回顾性分析方法对2012年1月～2014年1月2家大型综合性医院呼吸科和重症加强护理病房（Intensive Care Unit，ICU）确诊的属于院内获得性肺炎的多重耐药鲍曼不动杆菌肺炎84例患者，随机分为对照组和治疗组（n＝42），对照组采用头孢哌酮舒巴坦治疗，治疗组采用替加环素联合异帕米星治疗。比较2组患者的临床有效率、细菌清除率及不良反应发生情况。结果对照组和治疗组病情急性生理学及慢性健康状况评分（acute physiology and chronic health evaluation scoring system II，APACHE II）评分2组无差异。治疗组临床有效率为88％，高于对照组的61.9％（P＜0.05）；治疗组细菌清除率为59.5％，高于对照组的35.7％（P＜0.05）；不良反应发生率2组分别为7.1％和11．9％，无显著性差异。结论替加环素联合异帕米星治疗多重耐药鲍曼不动杆菌肺炎临床疗效显著，其不良反应少，安全性高。展开更多
Background: Due to extensive use of antibiotics, multidrug resistance of Acinetobacter baumannii (A.b) infection has become one of the major challenges in clinic, which is difficult to treat and have a high mortality ...Background: Due to extensive use of antibiotics, multidrug resistance of Acinetobacter baumannii (A.b) infection has become one of the major challenges in clinic, which is difficult to treat and have a high mortality rate. Based on this, we must take pro active measures against antimicrobial resistance by improving the efficacy. To provide a high-quality clinical evidence, a meta-analysis was conducted to compare the efficacy and safety of three anti-infection therapeutic regimens for the treatment of multidrug resistance of Acinetobacter baumannii(MRAB) infection. Methods: A meta-analysis of 36 randomized controlled trials, comprising approximately 3014 patients, was conducted to compare the efficacy and safety of three anti-infection therapeutic regimens for the treatment of MRAB infection. The clinical response rate and microbiological response rate between cefbperazone-sulbactam group and tigecycline plus cefbperazone-sulbactam group were RR=1.33, 95% CI= 1.27-1.39 and RR=1.72, 95% CI=1.55-1.90, respectively;Cefoperazone-sulbactam group and tigecycline plus isepamicin group were RR=1.29, 95% CI=1.19-1.39 and RR=1.59, 95% CI=1.37-1.84, respectively. Results: There was no significant difference between tigecycline plus cefbperazone-sulbactam group and tigecycline plus isepamicin group in the clinical response rate or microbiological response rate. Neither was there any adverse events (AEs) among the three regimens. Conclusion: Our finding suggested that tigecycline combined with cefbperazone-sulbactam or isepamicin may be performed with more efficacy than cefoperazone-sulbactam monotherapy in MRAB infections treatment.展开更多
文摘目的：观察替加环素联合异帕米星治疗多重耐药鲍曼不动杆菌肺炎的临床治疗效果。方法采用回顾性分析方法对2012年1月～2014年1月2家大型综合性医院呼吸科和重症加强护理病房（Intensive Care Unit，ICU）确诊的属于院内获得性肺炎的多重耐药鲍曼不动杆菌肺炎84例患者，随机分为对照组和治疗组（n＝42），对照组采用头孢哌酮舒巴坦治疗，治疗组采用替加环素联合异帕米星治疗。比较2组患者的临床有效率、细菌清除率及不良反应发生情况。结果对照组和治疗组病情急性生理学及慢性健康状况评分（acute physiology and chronic health evaluation scoring system II，APACHE II）评分2组无差异。治疗组临床有效率为88％，高于对照组的61.9％（P＜0.05）；治疗组细菌清除率为59.5％，高于对照组的35.7％（P＜0.05）；不良反应发生率2组分别为7.1％和11．9％，无显著性差异。结论替加环素联合异帕米星治疗多重耐药鲍曼不动杆菌肺炎临床疗效显著，其不良反应少，安全性高。
基金shandong Medical and Health science and technology Development Program(Project no.2017Ws201 and no.2047Ws029)
文摘Background: Due to extensive use of antibiotics, multidrug resistance of Acinetobacter baumannii (A.b) infection has become one of the major challenges in clinic, which is difficult to treat and have a high mortality rate. Based on this, we must take pro active measures against antimicrobial resistance by improving the efficacy. To provide a high-quality clinical evidence, a meta-analysis was conducted to compare the efficacy and safety of three anti-infection therapeutic regimens for the treatment of multidrug resistance of Acinetobacter baumannii(MRAB) infection. Methods: A meta-analysis of 36 randomized controlled trials, comprising approximately 3014 patients, was conducted to compare the efficacy and safety of three anti-infection therapeutic regimens for the treatment of MRAB infection. The clinical response rate and microbiological response rate between cefbperazone-sulbactam group and tigecycline plus cefbperazone-sulbactam group were RR=1.33, 95% CI= 1.27-1.39 and RR=1.72, 95% CI=1.55-1.90, respectively;Cefoperazone-sulbactam group and tigecycline plus isepamicin group were RR=1.29, 95% CI=1.19-1.39 and RR=1.59, 95% CI=1.37-1.84, respectively. Results: There was no significant difference between tigecycline plus cefbperazone-sulbactam group and tigecycline plus isepamicin group in the clinical response rate or microbiological response rate. Neither was there any adverse events (AEs) among the three regimens. Conclusion: Our finding suggested that tigecycline combined with cefbperazone-sulbactam or isepamicin may be performed with more efficacy than cefoperazone-sulbactam monotherapy in MRAB infections treatment.
