替考拉宁治疗耐甲氧西林金黄色葡萄球菌呼吸机相关性肺炎的临床研究

Clinical study on teicoplanin for ventilator-associated pneumonia caused by methicillin-resistant Staphylococcus aureus

目的评估替考拉宁治疗耐甲氧西林金黄色葡萄球菌呼吸机相关性肺炎的临床疗效。方法于2012年1月-2015年1月对ICU100例耐甲氧西林金黄色葡萄球菌感染的呼吸机相关性肺炎患者,给予替考拉宁静脉滴注治疗,给药方案为常规剂量联合个性化,评价指标包括临床症状、体征、实验室检查和不良反应。结果 100例患者治疗14d后痊愈36例、显效40例,总有效率为76.0%;细菌学检测结果表明,耐甲氧西林金黄色葡萄球菌清除率为79.0%,未出现其他细菌感染;不良反应发生率4.0%,表现为轻微肝、肾损害、皮疹和胃肠道反应。结论采用常规剂量给药联合个性化给药方案后,替考拉宁不仅能有效治疗耐甲氧西林金黄色葡萄球菌致呼吸机相关性肺炎,还能明显减少不良反应。

OBJECTIVE To assess the clinical efficacy of teicoplanin in treatment of patients with ventilator-associated pneumonia（VAP）induced by methicillin-resistant Staphylococcus aureus（MRSA）.METHODS From Jan.2012 to Jan.2015,100 patients from ICU with VAP induced by MRSA were treated with teicoplanin.Dosage regimen included routine dosage and personal dosage.The evaluation indexes were symptoms,signs,laboratory tests and adverse reactions.RESULTS After 14 days of teicoplanin treatment,36 of 100patients completely recovered and 40 had improvement.The total effective rate of clinical treatment was 76.00%and the bacterial clearance rate was 79.00%.There was no other bacterial infection.The incidence rate of adverse reactions was 4.00%,including mild damage to kidney and liver,rash and gastrointestinal reaction.CONCLUSION Application of the teicoplanin regimen combining routine dosage with personal dosage not only achieved high clinical effective rate,but also decreased adverse reactions.