氟喹诺酮类与万古霉素治疗皮肤感染的临床效果研究

Clinical effect of fluoroquinolones and vancomycin in treatment of skin infections

目的观察对中重度急性无合并症的复杂性皮肤感染中氟喹诺酮类与万古霉素治疗的临床效果,探讨氟喹诺酮类与万古霉素治疗皮肤感染的细菌清除率。方法选择2012年2月-2013年2月医院收治的148例中重度皮肤感染患者,按GCP要求签署知情同意书,随机平均分为观察组和对照组各74例,对照组患者均根据药物适应证常规给氟喹诺酮类药物,观察组在此基础上联合万古霉素治疗,观察对比两组临床疗效,采用总体统计方法,连续数据用t检验,分类数据用F检验。结果治疗结束第1天,观察组临床有效率为83.78%,明显优于对照组的67.57%;治疗第7天,观察组临床有效率为20.27%,明显优于对照组的17.57%;治疗结束第1天细菌清除率观察组100.00%、对照组91.89%,两组比较差异无统计学意义,治疗第7天细菌清除率观察组62.16%、对照组51.35%,两组比较差异无统计学意义。结论对中重度急性无合并症的复杂性皮肤感染,在单纯应用氟喹诺酮类抗菌药物达不到理想疗效时,可谨慎联合万古霉素治疗,不失是一个最佳的治疗措施。

OBJECTIVE To explore the moderate to severe acute uncomplicated complex skin infections by using fluoroquinolones and vancomycin; and explore the bacterial clearance rate of fluoroquinolones and vancomycin in treatment on skin infections. METHODS A total of 148 cases of patients with moderate to severe skin infections admitted to the hospital from Feb 2012 to Feb 2013 were selected. After signing an informed consent form accord- ing to GCP requirements, they were randomly divided into an observation group and a control group, each consis- ting of 74 patients. The patients in the control group were given conventional fluoroquinolones according to indica- tions of drugs; the patients in the observation group were given vancomycin on the same basis. The clinical effica- cy was observed and contrasted, making use of general statistical methods, with the t test for continuous data and F test for categorical data. RESULTS At the end of the first day of treatment, the clinical effective rate of the observation group was 83.78%, significantly better than 67.57% in the control group% on the seventh day of treatment, the clinical effective rate of the observation group was 20.27%, significantly better than 17.57% in the control group. By the first day at the end of treatment, the bacterial clearance rate of the observation group was 100.00 %, with 91. 89% in the control group, thus no significant difference was observed for the two groups. On the seventh day of treatment, the bacterial clearance rate of the observation group was 62.26 %, with 51.53% in the control group, thus no significant difference was observed for the two groups. CONCLUSION As to moderate to severe acute uncomplicated complex skin infections, in case that simple application of fluoroquinolone antibiotics can not reach the desired effect, it can be carefully combined with vancomycin, which can be regarded as the best treatment measure.