替考拉宁与万古霉素治疗重症革兰阳性菌感染的疗效和安全性

Teicoplanin and Vancomycin in Treatment of Severe Gram-positive Bacterial Infections:A Clinical Evaluation

目的评价替考拉宁与万古霉素治疗革兰阳性菌感染的疗效和安全性。方法采用随机对照及开放性试验，对68例重症革兰阳性菌感染患者，分别给予替考拉宁与万古霉素治疗，以万古霉素为对照，其中试验组34例，替考拉宁针第1天0．4g，1次／lzh，静脉滴注；此后0．4g，1次／d，静脉滴注；对照组34例，万古霉素1．0g，1次／8h，静脉滴注，疗程10～21d。结果试验组痊愈率、有效率、细菌清除率分别为55．9％、85．3％、89．2％；对照组分别为55．9％、88．2％、88．2％，组间差异无统计学意义；不良反应发生率分别为2．9％和11．8％，两组差异无统计学意义。结论替考拉宁治疗重症革兰阳性菌感染安全有效，对临床高度怀疑耐甲氧西林葡萄球菌或肠球菌感染时，可考虑初始经验性使用。

OBJECTIVE To study the safety and efficiency of teicoplanin and vancomycin in treatment of severe Gram-positive bacterial infections. METHODS In the randomized, controlled and opened clinical trial, 68 patients with severe Gram-positive bacterial infection were treated with teicoplanin and vancomycin. They were equally divided to receive once daily dose of 0.4 g teicoplanin with twice daily dose for the first day given by infusion for 10 -21 d or 3 times daily dose of 1.0 g intravenous vancomycin for 10-21 d. RESULTS The cure rate,total effective rate and bacterial clearance rate were 55. 9%, 85. 3%and 89.2%, respectively, for teicoplanin group 55.9%, 88.2% and 88.2 %, respectively, for control group. The adverse drug reactions occurred in teicoplanin group was 2.9% and in vancomycin group was 11.8%. CONCLUSIONS Teicoplanin is a highly effective and safe for severe Gram-positive bacterial infections. In highly suspected infections with meticillin-resistant staphylococci or enterococci, teicoplanin can be a choice for initial treatment.