舒普深(头孢哌酮钠/舒巴坦钠)治疗中重度下呼吸道感染临床观察及分析

目的研究舒普深在治疗中重度下呼吸道感染中的有效性和应用价值。方法回顾性研究我院2006年3月～2009年2月使用舒普深治疗下呼吸道中重度感染,观察其临床和细菌学效果及安全性。结果1356例不同下呼吸道中重度感染患者,其性别、年龄、发热程度、血白细胞与中性粒细胞、病原体种类和构成,均无明显差异。治疗的总有效率为85.15%,治疗前共分离出细菌1178株,细菌清除率91.46%,最大清除率93.12%。肺炎链球菌、溶血性链球菌、流感与副流感嗜血杆菌、金黄色葡萄球菌(非MRSA)及肺炎克雷伯氏菌,对舒普深具有很高的敏感性(89%～100%)。社区感染中较少的革兰氏阴性杆菌如大肠艾希氏菌、粘质沙雷菌和其他非发酵菌的敏感性亦偏高(85%～91%)。医院内获得性感染如产ESBL的铜绿假单胞菌、鲍曼不动杆菌及产青霉素酶的葡萄球菌等,其敏感性也不错,达到85%左右。舒普深的不良反应发生率低(3.91%),主要为胃肠道反应,用药后随访肝肾功能均未发现明显异常。结论舒普深对呼吸道常见病原菌具有良好的抗菌活性,对院内感染常见的产酶病原菌亦有不错的抗菌作用,治疗效果较好,细菌清除率高,不良反应少而轻微,较适合于中重度的下呼吸道感染。

Objective To explore the effective and applicative values of Sulperazon in the treatment of moderate to severe lower respiratory tract infection. Metthods A retrospective study on the Sulperazon treatment of moderate to severe lower respiratory tract infection in our hospital from March 2006 to February 2009, to observe the clinical and bacteriological efficacy and safety. Results For 1356 cases of moderate to severe lower respiratory tract infection, their sex, age, degree of fever, white blood cells and neutrophils, the type and composition of the pathogen showed no significant difference. The total effective rate of treatment was 85.15%, the isolated bacteria before treatment were 1178, the clearance rate of bacterial was 91.46%, the maximum clearance rate was 93.12%. Streptococcus pneumoniae, hemolytic streptococcus, influenza and haemophilus parainfluenzae, staphylococcus aureus （non-MRSA） and Klebsiella pneumoniae all showed high sensitivity （89%- 100%） on Sulperazon. Less of community-acquired gram-negative bacilli such as Escherichia Klebsiella, Serratia marcescens and other non-fermentative bacteria have a higher sensitivity （85%- 91%）. Hospital-acquired infections, such as ESBL production in Pseudomonas aeruginosa, Acinetobacter baumannii and Staphylococcus aureus producing enzymes such as penicillin, the sensitivities were quite well, reaching about 85%. The adverse reactions of Sulperazon was low （3.91%）, mainly showed gastrointestinal reaction, the abnormal of hepatic and renal function after administration were not found. Conclusion Sulperazon have good antibacterial activity on common respiratory pathogens and common nosocomial infection pathogen enzyme production, have better treated effects, bacterial clearance rate, and slightly fewer adverse reactions. It was more suitable in China severe lower respiratory tract infection.