替考拉宁治疗老年重症革兰阳性菌肺炎临床疗效评估

Teicoplanin in elder patients with severe gram-positive bacterial pneumonia:a clinical evaluation

目的探讨3种糖肽类抗菌药物治疗老年重症肺炎患者疗效及安全性。方法采用随机对照及开放性试验,82例革兰阳性菌感染的老年重症肺炎患者,随机分为两组,分别给予国产和进口替考拉宁治疗,替考拉宁针剂前3d用0.4g,1次/12h,以后为0.4g,1次/d,静脉滴注21d;对照组年轻重症肺炎患者30例,给予去甲万古霉素治疗,0.8g静脉滴注,14d。结果 3组患者临床有效率、痊愈率、细菌清除率国产替考拉宁组分别为85.7%、57.1%、95.2%;进口替考拉宁组分别为85.0%、57.5%、97.5%,去甲万古霉素组为86.7%、60.0%、90.0%,组间差异无统计学意义;不良反应发生率分别为4.8%、5.0%、53.3%,差异有统计学意义(P<0.05)。结论 3种糖肽类药物治疗革兰阳性球菌重症肺炎均有良好疗效,但替考拉宁不良反应明显低于去甲万古霉素,国产及进口均是老年革兰阳性菌重症肺炎患者的良好选择。

OBJECTIVE To study the safety and efficacy of three glycopeptide antibiotics in treatment of the elder patients with severe pneumonia.METHODS In the randomized,contrlled and opened clinical trial,82 severe elder patients presented with gram-positive cocci pneumonia were randomly divided to two groups,and treated with domestic teicoplanin and imported teicoplanin.30 yourger patients with severe pneumonia were treated with norvancomycin.RESULTS The total effective rate,cure rate and bacterial clearance rate of domestic teicoplanin were 85.7%,57.1%,and 95.2%,respectively,for imported teicoplanin group 85.0%,57.5%and 97.5%,respectively,for norvancomycin group 86.7%,60.0% and 90.0%.There were no statistical differences between the three groups.Adverse drug reactions occurred in teicoplanin group 4.8% and 5.0%,in vancomycin group 53.3%.Norvancomycin group and two teicoplanin groups had significant statistically differences（P0.01）.CONCLUSION Three glycopeptide antibiotics seems to be a highly effective for treatment of the patients with severe gram-positive cocci pneumonia.Teicoplanin had less adverse drug reactions,domestic teicoplanin and imported of teicoplanin can be a choice for the elder patients with severe gram-positive cocci pneumonia.