利奈唑胺与万古霉素治疗耐甲氧西林金葡菌所致呼吸机相关性肺炎的比较

Comparison of Linezolid and Vancomycin in the Treatment of Ventilator-associated Pneumonia Induced by MRSA

目的:评价和比较利奈唑胺与万古霉素治疗重症监护病房耐甲氧西林金葡菌(MRSA)所致呼吸机相关性肺炎的有效性及安全性。方法:采取随机、对照、开放的临床试验研究,选取重症监护病房确诊的MRSA所致呼吸机相关性肺炎患者54例。将入选患者随机分为2组,利奈唑胺组(24例),每次600mg,每隔12h一次,静脉滴注,治疗时间10d;万古霉素组(30例),每次500mg,每隔8h一次,静脉滴入,治疗时间10d。观察2组患者的疗效和不良反应。结果:利奈唑胺组有效率100%,MRSA清除率87.5%,不良反应率12.5%;万古霉素组有效率66.7%,MRSA清除率43.3%,不良反应率13.3%。2组有效率和MRSA清除率有显著性差异(P<0.05)。结论:对重症监护病房MRSA所致呼吸机相关性肺炎的治疗,利奈唑胺有效性优于万古霉素。

OBJECTIVE： To compare the efficacy and safety of linezolid vs. vancomycin in the treatment of MRSA-inducing ventilator-associated pneumonia in ICU. METHODS： In randomized controlled trials, 54 patients with MRSA-inducing ventilator-associated pneumonia in ICU were randomly divided into 2 groups. Linezolid group （n=24） were administered with linezolid 600 mg every 12 h for 10 days, ivgtt. Vancomycin group （n=30） were given vancomycin 500 mg every 8h for 10 days ivgtt. Adverse events and the efficacy of two groups were investigated. RESULTS： Comparison results of linezolid group vs. vancomycin group were as follows： effective rates： 100% vs. 66.7%, MRSA eradication rates： 87.5% vs. 43.3%, adverse reactions rates： 12.5% vs. 13.3%. There were significant differences in the effective rates and MRSA eradication rates between two groups. CONCLUSION： The efficacy and safety of linezolid in the treatment of MRSA-inducing ventilator-associated pneumonia is superior to vancomycin.