腹膜透析相关性腹膜炎抗生素初始治疗方案探讨

Comparison of initial antibiotic therapies in peritoneal dialysis-related peritonitis

目的探讨头孢唑啉联合头孢他啶与万古霉素联合头孢他啶作为腹膜透析相关性腹膜炎初始治疗的效果。方法回顾性分析2006年1月至2009年5月在北京大学第三医院收治的合并腹膜透析相关性腹膜炎的患者90例。其中37例次采用头孢唑啉＋头孢他啶治疗，97例次采用万古霉素＋头孢他啶治疗。比较其初始治疗的有效率、最终转归、细菌培养和药物敏感试验情况。结果头孢哗啉＋头孢他啶组患者腹膜炎的初始治疗有效率为81．1％，万古霉素＋头孢他啶组为86．2％，两组间差异无统计学意义（P〉0．05）；两组患者的G＋细菌感染分别为56．8％和50．5％，差异无统计学意义（P〉0．05）；两组患者在发病3周后治愈率分别为91．9％和97．9％，差异无统计学意义（P〉0．05）。结论头孢唑啉联合头孢他啶与万古霉素联合头孢他啶均可以作为腹膜透析相关性腹膜炎的初始治疗方案，且疗效相当。

Objective To evaluate the efficiency of cefazolin plus ceftazidime and vaneomycin plus ceftazidime as initial therapy for peritoneal dialysis （PD）-related peritonitis. Methods Retrospective analysis of 90 PD-related peritonitis from January 2006 to May 2009. Thirty-seven episodes were treated with cefazolin plus ceftazidime （CC group）, and 97 episodes with vancomycin plus cefiazidime （VC group）. Primary efficiency, outcomes, pathogenesis and resistance were analyzed respectively. Results The primary efficiency of CC group and VC group was 81.1% and 86.2%, respectively （P〉O.05）. Gram-positive organisms of CC group and VC group was 56.8% and 50.5%, respectively （P〉0.05）. The cure rate was 91.9% in CC group and 97.9% in VC group （P〉0.05）. Conclusion Cefazolin plus cefiazidime and vancomycin plus ceftazidime have similar efficiency as an initial therapy for PD-related peritonitis.