哌拉西林/他唑巴坦治疗多发性骨髓瘤患者医院感染的疗效与安全性分析

Efficacy and safety of piperacillin/tazobactam for empirical treatment of nosocomial infection in patients with multiple myeloma

目的评价哌拉西林/他唑巴坦治疗多发性骨髓瘤患者医院获得性感染的疗效和安全性。方法回顾性分析多发性骨髓瘤患者医院感染的病原菌分布、哌拉西林/他唑巴坦的疗效和不良反应,并与同期接受头孢吡肟或三代头孢菌素治疗者进行比较。结果 223例次住院患者中共发生87例次医院感染,细菌培养共获得35株病原菌;哌拉西林/他唑巴坦治疗总有效率为82.35%,不良反应发生率为2.94%,头孢吡肟组总有效率为77.78%,两组疗效相当(P=0.655),三代头孢菌素组总有效率为55.56%,较前两组为低(P=0.034);各组间不良反应差异无统计学意义。结论哌拉西林/他唑巴坦治疗多发性骨髓瘤患者医院获得性感染高效、安全,可作为一线的经验性用药。

OBJECTIVE To evaluate the efficacy and safety of piperacillin/tazobactam for the empirical treatment of nosocomial infection in patients with multiple myeloma.METHODS A retrospective analysis was conducted concerning the pathogens of nosocomial infection in patients with multiple myeloma.The efficacy and adverse reaction of piperacillin/tazobactam were compared with cefepime or third-generation cephalosporines.RESULTS A total of 87 case-times of hospital-acquired infection occurred out of 223 case-times of hospitalization.35 strains of bacteria were defined.The total effective rate was 82.35% and the adverse reaction rate was 2.94% in patients treated with piperacillin/tazobactam,while the effective rates of cefepime and third-generation cephalosporines were 77.78%（P=0.655）and 55.56%（P=0.034）respectively.There were no statistical significance among groups in terms of adverse reaction rate（P=0.368）.CONCLUSION Piperacillin/tazobactam is effective and safe as first-line empirical antibacterial therapy in multiple myeloma patients complicated with nosocomial infection.