替考拉宁与万古霉素治疗MRSA下呼吸道感染的临床疗效和安全性分析

Efficacy and safety of Teicoplanin and Vancomycin for Treatment of lower respiratory infection caused by MRSA

目的对替考拉宁与万古霉素治疗耐甲氧西林金黄色葡萄球菌(MRSA)下呼吸道感染的临床疗效和安全性进行分析。方法回顾性分析2013年6月至2014年12月我院收治的53例MRSA下呼吸道感染患者的临床资料,其中22例应用替考拉宁治疗(替考拉宁组),31例应用万古霉素治疗(万古霉素组);分别对其治疗前后的临床症状、体征、临床疗效、细菌清除情况以及不良反应进行分析,并将临床分离菌分别进行替考拉宁和万古霉素的体外药敏试验。结果替考拉宁组治疗时间平均(9.2±3.1)d,显著性低于万古霉素组的(14.9±3.3)d(P<0.01)。替考拉宁组总有效率为77.3%,万古霉素组为77.4%,两组比较差异无统计学意义(χ2=0.000,P>0.05)。替考拉宁组细菌清除率为72.7%,万古霉素组为83.9%,两组比较差异无统计学意义(χ2=0.972,P>0.05)。药敏试验结果显示替考拉宁和万古霉素对痰液MRSA分离菌均有极强的抗菌活性。替考拉宁组出现与药物很可能和可能有关的不良反发生率为9.1%,万古霉素组为16.1%,两组比较差异无统计学意义(χ2=0.062,P>0.05)。结论替考拉宁和万古霉素治疗MRSA下呼吸道感染疗效均较好,安全性高,但替考拉宁较之万古霉素使用时间更短。

Objective To analyze the efficacy and safety of Teicoplanin and Vancomycin in treatment of lower respiratory infection with MRSA.Methods The clinical data of 53 patients with MRSA infection of lower respiratory tract who were admitted in our hospital from June 2013 to December 2013 were analyzed retrospectively,including 22 cases treated with Teicoplanin and 31 cases with Vancomycin.The clinical symptoms and signs,clinical efficacy,bacteria clearance and adverse reactions before and after the treatment were analyzed.The susceptibility of the pathogens against Teicoplanin and Vancomycin were detected in vitro.Results The average treatment time of the Teicoplanin group was 9.2±3.1days,significantly shorter than that of the Vancomycin group（14.9±3.3days）（P〈0.01）.The total efficiency rate in the Teicoplanin group was 77.3%and that in the Vancomycin group was 77.4%（χ2=0.000,P〈0.05）.The bacteria clearance rate of the Teicoplanin group was 72.7%,while that in the Vancomycin group was 83.9%;the difference was not statistically significant（χ2=0.972,P〈0.05）.Both Teicoplanin and Vancomycin showed strong antibacterial activity against MRSA.The incidence of adverse reaction in the Teicoplanin group was 9.1%,lower than that in the Vancomycin group 16.1%,but without statistical significance（χ2=0.062,P〈0.05）.Conclusion Either Teicoplanin or Vancomycin has satisfactory efficacy and safety for treatment of MRSA infection of lower respiratory tract,but the course of treatment with Vancomycin is shorter than that with Teicoplanin.