亚胺培南和环丙沙星治疗耐头孢他啶阴性菌下呼吸道感染

Retrospect study on patients with lower respiratory tract infection due to ceftazidime resistant Gram negative pathogens treated with imipenem and ciprofloxacin

对我院近三年确诊为耐头孢他啶阴性菌下呼吸道感染５９例住院患者，回顾性比较了亚胺培南和环丙沙星临床疗效、细菌清除率和不良反应发生情况，并比较了两种药对患者下呼吸道分离的９６株阴性致病菌体外抗菌活性。结果表明：亚胺培南治疗组有效率、细菌清除率和不良反应率与环丙沙星治疗组比较无显著性差异。对治疗前分离的铜绿假单胞菌，环丙沙星抗菌活性强于亚胺培南；对产Ⅰ型诱导酶肠杆菌、克雷伯氏菌和大肠杆菌则两种药抗菌活性大致相同。因此，治疗耐头孢他啶阴性菌下呼吸道感染或者针对头孢他啶经验性治疗失败病例需要替换选用其它抗菌药物时，亚按培南和环丙沙星均可作为首选方案予以应用。

hospitalized patients with lower respiratory tract infections due to ceftazidime resistant Gram negative pathogens were treated with imipenem and ciprofloxacin in recent three years. The clinical and bacteriological response rates were 82.1%, 75.6% respectively in the imipenem gruop; and 77.4%, 70.6% respectively in the ciprofloxacin group. There were no significant differences between the two groups in the clinical and bac teriological responses and in the adverse effects ( P >0.05). The in vitro activities of the two drugs against 96 pathogens isolated from the patients were compared. Results showed that the activity of ciprofloxacin against Pseudomonas aeruginosa was stronger than that of imipenem; and the two drugs had the same or close activities against Enterobacteriaceae, E.coli and Klebsiella spp. The MICs of two drugs against the strains isolated from the fail cases increa sed during the treatments, and resistant rates of these strains changed from 0 to 66.7%￣100%.