替考拉宁治疗肺结核合并肺部革兰阳性球菌感染的疗效与安全性评价

Efficacy and safety of teicoplanin on treatment of pulmonary tuberculosis combined with gram-positive cocci infection in lungs

目的比较国产替考拉宁和万古霉素治疗肺结核合并肺部感染革兰阳性球菌的疗效与安全性。方法确诊的肺结核合并肺炎患者103例,53例使用国产替考拉宁治疗,50例使用万古霉素治疗,分析对比使用不同抗菌药物的疗效、细菌清除率、不良反应。结果国产替考拉宁的有效率为88.7%,细菌清除率为84.9%,不良反应的发生率为3.8%;万古霉素的有效率为86.0%,细菌清除率为78.0%,不良反应的发生率略高为6.0%,两组比较差异虽无统计学意义,但替考拉宁的有效率和细菌清除率均高于万古霉素;替考拉宁和万古霉素对肠球菌属的清除率分别为100.0%和42.9%,替考拉宁组高于万古霉素组(χ2=6.234,P=0.026),差异有统计学意义。结论国产替考拉宁是治疗肺结核合并肺部革兰阳性球菌感染的有效药物,尤其对肠球菌属的细菌清除率达100.0%,优于万古霉素,不良反应少,价格低廉。

OBJECTIVE To compare the efficacy and safety of teicoplanin and vancomycin on treatment of pulmonary tuberculosis complicated by Gram-positive cocci in lung. METHODS Among 103 patients diagnosed of pulmonary tuberculosis and lung infection, 53 were treated with teicoplanin and 50 were treated with vancomycin. The therapeutic outcomes, clearance rates of pathogens and adverse effects were analyzed. RESULTS The treatment outcomes of teicoplanin and vancomycin were all well. Effective rates of teicoplanin and vancomycin were 88.7% and 86.0% ,respectively （P〉0.05）. Clearance rate of pathogens and incidence of adverse event for teicoplanin were 84.9% and 3.8%. Clearance rate of pathogens and incidence of adverse event for vancomycin were 78.0% and 6.0%. Although there was no statistic significance between the two groups （P〉0.05）, the effective rate and clearance rate of pathogens were all higher in patients treated by teicoplanin. The clearance rates of enterococcus for teicoplanin and vancomycin were 100. 0% and 42. 9%, respectively , there was statistical significance （χ^2= 6. 234, P= 0. 026）. CONCLUSION Teicoplanin is an effective drug in treating pulmonary tuberculosis with Gram-positive cocci lung infection. The clearance rate of enterococcus is 100.0 %, and it is better than vancomycin, with the less adverse effect and cheapness.