替考拉宁治疗ICU耐甲氧西林金黄色葡萄球菌感染的疗效观察

Teicoplanin Used for Severe Infected Patients with MRSA in Intensive Care Unit

目的观察替考拉宁治疗重症监护病房（ICU）耐甲氧西林金黄色葡萄球菌（MRSA）感染的有效性和安全性。方法收集2007年1月-2009年5月重庆医科大学附属第二医院中心ICUMRSA感染患者52例，包括败血症19例、肺炎24例、骨关节感染3例、尿路感染2例、肠炎4例，应用替考拉宁控制感染，用量400mg，1次／d，静脉给药，首日给予负荷量400mg，疗程11．2（4-21）d，观察临床疗效和安全性。结果用药前MRSA对替考拉宁的敏感率为100．0％，治疗后痊愈24例，显效16例，好转7例，无效5例（3例死于多器官功能障碍），总有效率为76．9％，因不能排除与替考拉宁相关性不良反应而停用或更改抗菌药物3例，可疑不良反应发生率5．77％。结论替考拉宁是治疗ICU患者MRSA感染的一种安全有效的药物。

OBJECTIVE To observe the clinical efficacy and safety of teicoplanin in treatment of MRSA in ICU. METHODS A total of 52 patients with MRSA infection in ICU of the Second Affiliated Hospital of Chongqing Medical University were given teicoplanin 400mg qd by iv with initial loading dose of 400rag, the mean duration of the treatment was 11.2 days（ranged for 4 to 21 days）. The clinical efficacy and safety were observed. RESULTS All MRSA bacteria isolated were sensitive to teicoplanin, with using teicoplanin, 24 patients in this group were clinically cured,16 patients were remarkably effective,and 7 patients were improved,but 5 patients were failed in treatment including 3 patients died of multiple-organ dysfunction（MODF）. The total effective rate was 76.9%. Teicoplanin had to be stopped or changed to other antibiotics in 3 patients because there was no good way to excluding the adverse events （side effect rate 5.77 %）. CONCLUSIONS Teicoplanin is an effective and safe drug in treatment of MRSA infection in ICU.