氯霉素联合红霉素治疗多重耐药铜绿假单胞菌肺炎21例临床分析

Clinical analysis of chloramphenicol combined with erythromycin in treatment of multi-drug resistance P. Aeruginosa pneumonia in 21cases

目的:探讨氯霉素联合红霉素治疗多重耐药铜绿假单胞菌肺炎的疗效。方法:对我院发生的医院获得性肺炎患者21例的临床资料、耐药性特点及药敏试验结果进行分析。结果:21例患者均对第三代头孢菌素和第三代氟喹诺酮类抗菌药物耐药。对亚胺培南/西司他汀中介16例,耐药5例。给氯霉素联合红霉素治疗,治愈12例,好转5例,无效4例。治愈率57.14%,好转率23.8%,临床总有效率(治愈率+好转率)为80.94%。结论:ICU内医院获得性肺炎铜绿假单胞菌肺炎发生率高,耐药性强,治疗困难;及时发现耐药并合理使用抗生素有利于治疗与预防铜绿假单胞菌感染医院获得性肺炎肺炎。

Objective：To study the efficacy of chloramphenicol combined with erythromycin in treatment of pneumonia infected by multi-drug resistance P.Aeruginosa.Methods：The retrospective analysis on 21 cases of pneumonia infected by mult-drug resistance P.Aeruginosa from January 2007 to December 2010 was carried out.The clinical features,drug-resistant features and results of susceptibility test were analysed.Results：All of 21 patients were resistant to the third generation cephalosporin and carbostyrils.The treatment with imipenem and sodium cilastatin showed mesomerism in 16 cases and drug resistance in 5 cases.But,in the treatment of chloramphenicol combined with erythromycin,12 cases were cured,5 cases were improved,and 4 cases were ineffective.The cure rate was 57.14% and the improvement rate was 23.8 % with the total effective rate of 80.94%.Conclusion：The incidence rate of pneumonia associated with P.Aeruginosa is higher in ICU,which has high drug resistance and is difficult to be treated.Diagnosis in time and rational antibiotic use benefit to cure and prevent hospital acquired pneumonia caused by P.Aeruginosa.