美罗培南治疗早产儿重症细菌感染的临床疗效及安全性评价

Clinical Evaluation of Meropenem in Preterm Neonates for Severe Infections

目的:评价美罗培南对早产儿重症细菌感染的疗效及安全性。方法:106例严重细菌感染的早产儿,在常规治疗无效后,根据血培养药敏试验改用美罗培南静脉注射,同时观察用药前后疗效和不良反应。结果:临床有效率为80.94%,对呼吸机相关性肺炎及败血症的有效率分别为90.48%8、9.66%;药物不良反应发生率为16.98%,主要为继发真菌感染。结论:在合理剂量和适当疗程的情况下,美罗培南是治疗早产儿多重耐药菌所致严重感染安全有效的抗菌药物,值得临床关注和进一步研究。

Objective：The aim of this paper was to evaluate the usefulness and safety of meropenem in premature infants with severe infections.Methods： We reported the use of meropenem in 106 infants with severe infections from August 2009 to May 2011.In all cases meropenem was used as second choice.All infants deteriorated during their conventional treatment and were changed to meropenem monotherapy.Results： The incidence of drug-related adverse events（mainly fungal sepsis） was 16.98%.No adverse effects such as diarrhea,vomiting,thrombocytopenia,increase in creatinine or seizures were observed.At the end of the therapy,overall satisfactory clinical and bacterial response was obtained in 80.94%（85/106） of the premature infants treated with meropenem.Clinical and bacterial response rates for meropenem were 90.48% for ventilator-associated pneumonia（VAP） and 89.66% for sepsis.Conclusions： Evidence presented in this article demonstrates meropenem in preterm neonates for severe infections caused by multi-resistant organisms is safe and effective.Further studies are needed to confirm these results.