替加环素联合舒巴坦治疗泛耐药鲍氏不动杆菌肺部感染的临床疗效观察

Clinical efficacy of tigecycline combined with sulbactam in treatment of pulmonary infections caused by pandrug-resistant Acinetobacter baumannii

目的观察替加环素联合舒巴坦治疗泛耐药鲍氏不动杆菌肺部感染的临床疗效。方法选取2012年4月-2013年4月21例泛耐药鲍氏不动杆菌感染的临床病例作为观察对象,将21例患者随机分为碳青霉烯类组(A组),碳青霉烯类联合舒巴坦组(B组),替加环素联合舒巴坦组(C组),每组各7例,3组患者在年龄、性别、住院天数、抗菌药物使用时间、基础疾病等方面差异无统计学意义,观察3组的细菌学疗效、临床疗效的变化以及安全性评价。结果替加环素联合舒巴坦治疗组临床痊愈率42.86%、有效率71.43%及细菌清除率66.70%,碳青霉烯类联合舒巴坦组分别为14.28%、42.86%、42.86%,碳青霉烯类组分别为0、28.57%、28.57%,3组比较差异有统计学意义(P<0.05),替加环素联合舒巴坦组未出现严重不良反应。结论替加环素联合舒巴坦对泛耐药鲍氏不动杆菌肺部感染具有良好的临床疗效及安全性,是一个值得推广的临床抗菌策略。

OBJECTIVE To observe the clinical efficacy of tigecycline combined with sulbactam in treatment of pulmonary infections caused by pandrug-resistant Acinetobacter baumannii.METHODS A total of 21cases of pulmonary infections caused by pandrug-resistant A.baumannii,who were treated in the hospital from Apr 2012 to Apr 2013,were enrolled in the study and were randomly divided into the carbapenems group（group A）,the carbapenems combined with sulbactam group（group B）,and the tigecycline combined with sulbactam group（group C）,with 7cases in each group;the three groups showed no statistical difference in the age,gender,length of hospital stay,time of use of antibiotics,or underlying diseases;the bacteriological efficacy and the therapeutic effect were observed and compared between the three groups,and the safety was evaluated.RESULTS The clinical cure rate was 42.86% in the tigecycline combined with sulbactam group,0 in the carbapenems group,14.28% in the carbapenems combined with sulbactam group;the effective rate was 71.43% in the tigecycline combined with sulbactam group,28.57% in the carbapenems group,42.86% in the carbapenems combined with sulbactam group;the bacterial eradication rate was 66.70% in the tigecycline combined with sulbactam group,28.57% in the carbapenems group,42.86% in the carbapenems combined with sulbactam group,the differences between the three groups were significant.The severe adverse reactions did not occur in the tigecycline combined with sulbactam group.CONCLUSIONThe tigecycline combined with sulbactam can achieve good clinical therapeutic effect on pulmonary infections caused by pandrug-resistant A.baumannii and is worthy to be promoted in the hospital.