不同剂量替加环素治疗多重耐药菌感染所致呼吸机相关性肺炎的观察

Observation on Different Doses of Tigecycline in the Treatment of Ventilatorassociated Pneumonia Caused by Multidrug-resistant Bacteria Infections

目的:观察不同剂量替加环素治疗多重耐药菌感染所致呼吸机相关性肺炎(VAP)的临床疗效。方法:回顾性分析2017年10月—2018年9月我院治疗的126例多重耐药菌感染所致VAP患者的临床资料,依据替加环素使用剂量的不同分为A组(40例,首次剂量100 mg静脉滴注,随后50 mg,1次/12 h)、B组(43例,持续100 mg静脉滴注,1次/12 h)、C组(43例,持续100 mg静脉滴注3~5 d,随后50 mg,1次/12 h)。观察三组临床疗效、临床指标、细菌清除效果及不良反应。结果:较A组、C组,B组治疗有效率、细菌清除率较高,替加环素治疗时间、住院时间较短,差异有统计学意义(P<0.05);C组住院时间短于A组,差异有统计学意义(P<0.05);三组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:多重耐药菌感染所致VAP患者接受高剂量替加环素治疗的效果确切,且安全性好,利于提升致病菌清除率。

Objective:To observe the clinical efficacy of different doses of tigecycline in the treatment of ventilator-associated pneumonia(VAP)caused by multidrug-resistant bacteria infections.Methods:The clinical data of 126 patients with VAP caused by multidrug resistance bacteria infections in our hospital from October 2017 to September 2018 were analyzed retrospectively,and the patients were divided into group A(40 cases,the first dose of 100 mg for intravenous infusion,followed by 50 mg,once per 12 h),group B(43 cases,continuous dose of 100 mg for intravenous infusion,once per 12 h)and group C(43 cases,continuous dose of 100 mg for intravenous infusion for 3~5 d,followed by 50 mg,once per 12 h)according to different doses of tigecycline.The clinical efficacy,clinical indexes,bacterial clearance effect and adverse reactions in the three groups were observed.Results:Compared with the group A and the group C,the group B had higher therapeutic effective rate and bacterial clearance rate,and shorter tigecycline treatment time and hospitalization time,and the differences were statistically significant(P<0.05).The hospitalization time in the group C was shorter than that in the group A,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the three groups(P>0.05).Conclusion:High-dose tigecycline is effective and safe in patients with VAP caused by multidrug-resistant bacteria infections,which is beneficial to improving the clearance rate of pathogens.