替加环素联合头孢哌酮/舒巴坦治疗泛耐药鲍曼不动杆菌的临床疗效评价

Clinical efficacy of tigecycline combined with cefperazone-sulbactam in treatment of pan-drug resistant Acinetobacter baumannii

目的评价替加环素与头孢哌酮/舒巴坦治疗泛耐药鲍曼不动杆菌的临床疗效。方法重症监护病房(ICU)收治的60例感染泛耐药鲍曼不动杆菌的患者随机分为研究组(n=30)和对照组(n=30),分别给予替加环素+头孢哌酮/舒巴坦和单纯头孢哌酮/舒巴坦治疗,疗程2周。比较两组的临床疗效、细菌清除率、白细胞(WBC)计数、C反应蛋白(CRP)和急性生理与慢性健康评分(APACHEⅡ)。结果研究组总有效率为83.33%(25/30),对照组为50.00%(15/30);研究组细菌清除率为56.67%(17/30),对照组为33.33%(10/30);两组治疗后的APACHEⅡ评分明显增加,WBC计数和CRP都明显降低。治疗后两组三项指标比较差异均具有统计学意义(t=3.852、5.167、4.221,P<0.05)。结论替加环素联合头孢哌酮/舒巴坦治疗泛耐药鲍曼不动杆菌能明显提高临床疗效和细菌清除率,优于单独使用头孢哌酮/舒巴坦。

Objective To evaluate the clinical efficacy of tigecycline combined with cefperazone-sulbactam in treatment of pan-resistant Acinetobacter baumannii.Methods 60 patients infected with pan-drug resistant Acinetobacter baumannii admitted in intensive care unit（ICU）were randomly divided into the study group or control group,who were given tigecycline ＋ cefperazone/sulbactam or cefperazone/sulbactam alone for 2weeks respectively.The clinical efficacy,bacterial clearance rate,white blood cell（WBC）count,C-reactive protein（CRP）and acute physiology and chronic health evaluation（APACHE Ⅱ）were evaluated and compared between the two groups.Results The total efficiency rate was 83.33%（25/30）in study group,obviously higher than the 50.00%（15/30）in control group（P〈0.05）.The bacterial clearance rate was56.67%（17/30）in study group,higher than the 33.33%（10/30）in control group（P〈0.05）.The APACHE Ⅱ scores significantly increased while WBC count and CRP significantly decreased in both groups（t=3.852,t=5.167,t=4.221;P〈0.05）.Conclusion The combination therapy of tigecycline plus cefperazone/sulbactam can obviously improve the clinical efficacy and bacterial clearance rate in treatment of pan-resistant Acinetobacter baumannii,superior to cefperazone/sulbactam alone.