美罗培南治疗中、重度烧伤感染的临床观察

Clinical evaluation of meropenem for the treatment of moderate and severe burn infection

目的评价美罗培南治疗烧伤后感染的疗效和安全性。方法6个烧伤治疗单位共48例中、重度烧伤感染患者，给予美罗培南0．5或1g／次，每日2g或酌情增减（小儿剂量20mg／kg×3次），疗程7～10d。观察用药后创面外观变化、细菌培养情况及实验室检查改变，并判断疗效。结果美罗培南应用后发热患者体温有不同程度下降，总改善率为66．7％；创面渗出减少，红肿消退；对烧伤创面常见病原菌均有较好的疗效，其中铜绿假单胞菌的清除率为68．4％（敏感株）和40％（耐药株）；白细胞总数及中性粒细胞均较用药前下降。所有病例均未出现明显不良反应。结论美罗培南能有效治疗烧伤后感染，无明显不良反应。

Objective To evaluate the efficacy and safety of meropenem in the treatment of moderate and severe burn infection. Methods A total of 48 patients in 6 burn departments were involved in this study. Meropenem was administered by intravenous injection at 2 g/day （0.5 or 1 g/time） for 7-10 days （20 mg/kg × 3/day for children）. Patients were evaluated before, during and after therapy. Results After meropenem was used, the fever was improved （66.7%）. Wound exudation and swelling decreased. Meropenem was active against common bacterial pathogens isolated from burn wound. The eradication rate of P. aeruginosa was 68.4% for susceptible strains and 40 % for resistant strains, respectively. Total white cell count and neutrophils were reduced. No adverse reaction was identified. Conclusions Meropenem is an effective and safe agent for moderate and severe burn infections.