替加环素联合头孢哌酮-舒巴坦治疗医院获得性泛耐药鲍氏不动杆菌肺炎10例

Curative effect of tigecycline combined with cefoperazane-sulbactam on 10cases of hospital-acquired pneumonia caused by pandrug-resistant Acinetobacter baummannii

目的了解替加环素联合头孢哌酮-舒巴坦治疗医院获得性泛耐药鲍氏不动杆菌肺炎的临床疗效和安全性。方法回顾分析本院2011年9月1日至2013年2月28日采用替加环素治疗的医院获得性鲍氏不动杆菌肺炎病例的临床治疗资料、治疗结果及不良反应情况。结果采用替加环素初始治疗及挽救治疗的10例医院获得性泛耐药鲍氏不动杆菌肺炎患者均联用了头孢哌酮-舒巴坦(3.0 g,q8 h^q6 h),疗程为4~20 d。其中替加环素常规维持剂量(50 mg,q12 h)治疗3例均治愈;替加环素加大维持剂量(75 mg^100 mg,q12 h)治疗7例,2例治愈,3例显效,2例无效死亡。总有效率为80%。不良反应主要表现为恶心、呕吐及腹泻等胃肠道症状,症状均较轻,对症治疗可缓解。结论替加环素联合头孢哌酮-舒巴坦治疗医院获得性泛耐药鲍氏不动杆菌肺炎有效、安全。

AIM To know the efficacy and safety of combination of tigecycline and cefoperazone-sulbactam for hospital - acquired pneumonia （HAP） caused by pan - drug resistant Acinetobacter baumannii. METHODS The clinical data of HAP patients caused by pan-drug resistant A cinetobacter baumannii from Sep 1, 2011 to Feb 28, 2013 were analysed retrospectively, including therapeutic process, treatment outcome and adverse drug reactions. RESULTS All the 10 patients with HAP treated with tigecycline in initial treatment and salvage treatment were combined with cefoperazone-sulbactam （3.0 g, q8 h - q6 h） for 4 to 20 days. Three patients treated with routine maintenance dosage of tigecycline （50 mg, q12 h） were cured; seven patients were treated with increased maintenance dosage of tigecycline （75 mg - 100 mg, q12 h）, of whom 2 werecured, 3 got marked effects, and 2 died. The overall effective rate was 80%. Nausea, vomit and diarrhea were common adverse reactions in the study. The symptoms were relatively light and could be alleviated by symptomatic treatment. CONCLUSION Tigecycline combined with cefoperazone-sulbactam is effective and safe in treatment of HAP caused by pan-drug resistant A cinetobacter baumannii.