泛耐药铜绿假单胞菌医院获得性肺炎抗感染疗效分析

Efficacy of anti-infection therapy in hospital-acquired pneumonia caused by pan-drug resistant Pseudomonas aeruginosa

目的:比较头孢哌酮舒巴坦单用和联合阿米卡星治疗泛耐药铜绿假单胞菌(PDRPA)所致医院获得性肺炎(HAP)的疗效。方法:将2012年6月至2013年12月份收治的84例PDRPA-HAP患者分为单用组(单用头孢哌酮舒巴坦)和联合组(头孢哌酮舒巴坦联合阿米卡星)。参照卫计委制定的《抗生素临床研究指导原则》相关标准评价抗感染疗效。结果:两组细菌清除率比较,差异有统计学意义(χ2=5.765,P=0.016);临床疗效比较,差异无统计学意义(χ2=2.791,P=0.095);药品不良反应比较,差异无统计学意义(P>0.05)。结论:头孢哌酮舒巴坦联合阿米卡星治疗PDRPA-HAP的细菌清除率优于单用头孢哌酮舒巴坦,值得进一步扩大研究观察。

Objective： To compare the efficacy of cefoperazone / sulbactam（ CPZ / SBT） alone vs in combination with amikacin in treatment of hospital-acquired pneumonia（ HAP） caused by pan-drug resistant Pseudomonas aeruginosa（ PDRPA）. Methods： Between June 2012 and December 2013,a total of 84 patients with PDRPA-caused HAP were divided into the monotherapy group（ CPZ / SBT alone） and the combination therapy group（ CPZ / SBT plus Amikacin）. The efficacy of anti-infection therapy was evaluated with reference to the ＂Guidelines on Clinical Studies Using Antibiotics ＂ by China Committee of Health and Family Planning.Results： The two groups showed statistically significant difference in bacterial clearance rate（ χ2= 5. 765,P =0. 016） but comparable clinical efficacy（ χ2= 2. 791,P = 0. 095）. There was statistically significant difference in adverse drug reactions between the groups（ P 〉 0. 05）. Conclusion： CPZ / SBT combined with amikacin results in higher bacterial clearance rate than CPZ / SBT alone in treatment of PDRPA-caused HAP,which warrants further observation in larger studies.