替加环素治疗高龄老年院内获得性肺炎的疗效及安全性分析

Effect and safety of tigecycline in the treatment of elderly patients with hospital-acquired pneumonia

目的观察替加环素治疗高龄老年院内获得性肺炎(HAP)耐药鲍曼不动杆菌感染的临床疗效与安全性。方法筛选2014年6月-2015年8月我院老年病科应用替加环素治疗多重或泛耐药鲍曼不动杆菌感染的高龄HAP病例,收集患者临床相关资料,总结分析其临床、细菌学疗效及药物安全性。结果共30例合格病例被纳入研究,分为两组:替加环素单药治疗组6例,临床有效3例,细菌清除1例。替加环素为基础联合其他抗生素治疗组24例,临床有效15例,死亡1例;细菌清除10例。临床总有效率为60%,细菌清除率36.7%。治疗前后患者肝肾功能无明显变化,治疗过程中出现恶心、欲吐不良反应1例。结论替加环素能有效改善高龄HAP耐药鲍曼不动杆菌感染患者的临床疗效,临床可尝试选用替加环素进行治疗,但同时需密切观察其不良反应。

Objective To evaluate the efficacy and safety of tigecycline in the treatment of elderly patients with hospital-acquired pneumonia （HAP） caused by drug resistant Acinetobacter baumannii. Methods All patients with HAP caused by multiple or extensive drug resistant Acinetobacter baumannii were screened out in our department of geriatrics from June 2014 to August 2015, and their clinical information were collected to analyze the clinical efficacy and drug safety. Results 30 eligible cases were enrolled in the study, and they were divided into two groups. The control group was only given tigecycline （ n = 6）, and the study group was given tigecycline combined with other antibiotics （n = 24）. In the control group, there were 3 clnical effective cases and 1 microbiology cleared case. In the study group, there were 15 clinical effective cases, 10 microbiology cleared cases and 1 case died. The total clinical efficacy rate was 60%, and the bacteria clearance rate was 36. 7% respectively. The function of hepatic and renal didn＇t change obviously after treatment. 1 case showed adverse drug reaction of feeling nausea and vomiting. Conclusion Tigecycline is effective in the treatment of elderly patients with HAP caused by drug resistant Acinetobacter baumannii. When the choice of antibiotics is limited, tigecycline can be applied, but its adverse reactions should be paid close attention.