利奈唑胺治疗非结核性分枝杆菌肺病1例报道

A case report about therapeutic effect of linezolid on pulmonary nontuberculous mycobacteria disease

目的观察含利奈唑胺治疗方案对非结核性分枝杆菌肺病的临床疗效、长疗程用药的安全性及不良反应。方法对1例确诊为高度耐药脓肿型分枝杆菌属感染的非结核性分枝杆菌肺病患者,根据药敏使用含利奈唑胺方案治疗后的临床资料进行回顾性分析,观察患者临床症状、细菌学改善、影像学表现和不良反应,并结合文献进行复习。结果患者接受利奈唑胺600mg每日1次静脉滴注联用克拉霉素及阿米卡星的治疗,利奈唑胺使用长达24周,临床症状缓解,肺部阴影吸收,右主支气管狭窄改善,痰非结核性分枝杆菌转阴。结论利奈唑胺具有抗非结核性分枝杆菌作用,与克拉霉素阿米卡星联用收到明显效果,未发现明显不良反应。

OBJECTIVE To observe the clinical efficay of pulmonary linezolid in treatment of nontuberculous myco-bacteria disease assess the safety of long course of medication, and analyze the adverse effect. METHODS A retro-spective analysis was performed for one patient with confirmed pulmonary nontuberculous mycobacteria diseasewhich was diagnosed as highly resistanted abscess type of mycobacterium infections and was treated with a thera-peutic protocol involving linezolid according to drug sensitivity. The patients＇ clinical symptoms, bacteriologicalimprovement, imaging results and adverse reactions were observed, and a review combined with literatures wascarried out. RESULTS After the patients received a linezolid （600mg/d intravenous dripping,once per day） thera-py combined with clarithromycin and amikacin for twenty-four weeks,their clinical symptoms were relieved,lungshadow were absorbed, right main bronchial stenosis was improved, and the nontuberculous mycobacteria in thesputum became negative. CONCLUSION Linezolid combined with clarithromycin and amikacin can achieve remark-ble efficacy in resisting nontuberculous mycobacteria, without significant adverse reactions detected.