替考拉宁治疗呼吸机相关性肺炎疗效与安全性评价

Evaluation of efficacy and safety of teicoplanin on treatment of ventilator-associated pneumonia(VAP)

目的评价替考拉宁治疗呼吸机相关性肺炎(VAP)的疗效与安全性。方法选择2010年3月-2013年1月入住医院ICU革兰阳性球菌感染导致的VAP患者87例,将其随机分为试验组和对照组,其中试验组44例患者给予国产替考拉宁400mg静脉滴注,12h给药1次,3个剂量后改为24h给药1次;对照组43例患者给予万古霉素1.0g静脉滴注,12h给药1次,比较两组患者临床疗效、细菌学疗效及不良反应发生率。结果临床痊愈率、有效率、细菌学清除率试验组分别为47.73%、79.55%、86.36%;对照组分别为53.49%、81.40%、88.40%,经χ2检验,差异无统计学意义;试验组与对照组的不良反应发生率分别为6.80%和9.30%,两组比较差异无统计学意义。结论国产替考拉宁治疗革兰阳性球菌引起的呼吸机相关性肺炎(VAP)疗效确切、安全性高,临床上确诊及高度怀疑革兰阳性球菌引起的VAP患者,可作为首选药物。

OBJECTIVE To evaluate the efficacy and safety of teicoplanin treatment in patients with ventilatorassociated pneumonia （VAP）. METHODS A total of 87 cases admitted to our hospital ICU with ventilatorassociated pneumonia caused by gram-positive cocci infection between Mar. 2010 and Jan. 2013 were selected. The patients were randomly divided into experimental group and control group. The experimental group （44 cases） began receiving intravenous domestic teicoplanin （400 mg per 12 hours）, then was adjusted to once per day after 3 dosages. The eontr01 group （43 cases） was given vancomycin 1.0 g per 12 hours by intravenous drip. The clinical effective rate, clearance rate of pathogens and adverse reaction rate were compared. RESULTS The rate of clinical recovery, effective rate, clearance rate of pathogens of the experimental group were 47. 7%, 79. 5%, 86.4% respectively, and control group were 53.5%, 81.4%, 88.4%, which were tested by Х^2 and no significant differences was found. Adverse reaction rates in the experimental group and the control group were respectively 6.8% and 9.3 %, and the two groups had no statistical significance. CONCLUSION It is high effective and safe to use domestic teicoplanin in the patients with VAP of gram-positive cocci infections. Domestic teicoplanin can be used as the preferred clinical medicine to confirmed or high suspected VAP patients caused by gram positive coccus.