阿奇霉素联合环丙沙星治疗碳青霉烯类耐药铜绿假单胞菌感染的临床疗效观察

Azithromycin combined with ciprofloxacin in treatment of carbarpenem-resistant Psendomonas aeruginosa infection

目的:观察阿奇霉素联合环丙沙星对碳青霉烯耐药铜绿假单胞菌感染的临床疗效。方法:27例耐药铜绿假单胞菌呼吸道感染患者随机分为试验组和对照组。试验组给予阿奇霉素0.5 g+5%葡萄糖注射液250 mL静脉滴注,而对照组给予5%葡萄糖注射液250 mL静脉滴注,完毕后2 h内两组均立即给予乳酸环丙沙星氯化钠注射液0.6 g静脉滴注,qd。两组疗程均为2周。结果:试验组总有效率92.86%,明显高于对照组的38.46%(P<0.05)。给药5 d后,试验组环丙沙星的最小抑菌浓度(MIC)显著降低(P<0.01),而对照组无明显变化(P>0.05)。结论:阿奇霉素可提高环丙沙星对临床碳青霉烯类耐药铜绿假单胞菌的抗菌活性,为临床治疗该类菌株感染提供了一条新的途径。

OBJECTIVE To study the clinical efficacy of azithromycin combined with ciprofloxacin in treatment of carbarpen- em-resistant Psendomonas aeruginosa infection. METHODS 27 patients were randomized to trial group and control group. The trial group was infused with azithromycin 0. 5 g ＋ 5 % GS 250 mL followed by the infusion of ciprofloxacin lactate and sodi- um chloride injection 0. 6 g with 2 hours interval; the control group was infused with 5%GS 250 mL followed by the infusion of ciprofloxacin lactate and sodium chloride injection 0. 6 g with 2 hours interval. The course of treatment for both group was 2 weeks. RESULTS The trial group was superior to control group in efficacy （92. 86% vs 38. 46% in total effective rates, P〈0. 05）. Ciprofloxacin MIC of the trial group was significantly lower （P〈0. 01）, while no significantly change in the control group（P〉0. 05）. CONCLUSION Azithromycin improve the antimicrobial activity of eiprofloxacin against carbarpenem-resist- ant Psendomonas aeruginosa and provided a new therapy approach.