头孢哌酮舒巴坦联合米诺环素治疗多重耐药鲍曼不动杆菌肺炎疗效评价

Curative effect of cefoperazone-sulbactam plus minocycline in the treatment of multidrug-resistant Acinetobacter baumannii. pneumonia

目的观察头孢哌酮舒巴坦联合米诺环素治疗多重耐药鲍曼不动杆菌肺炎的临床疗效。方法将63例多重耐药鲍曼不动杆菌医院获得性肺炎患者随机分为观察组和对照组,观察组应用头孢哌酮舒巴坦联合米诺环素（33例）,对照组应用头孢哌酮舒巴坦联合替加环素（30例）。观察WBC、CRP、PCT、体温、临床疗效和细菌清除率的变化。结果经过治疗后,观察组患者WBC为（7.04±1.87）×10~9,CRP为（4.34±2.90）mg/L,PCT为（1.04±0.50）mg/mL,较治疗前明显下降（P〈0.05）。观察组治疗总有效率为69.70%,细菌清除率为45.5%,与对照组比较差异均无统计学意义（P〉0.05）。观察组体温下降至正常时间为（3.76±1.15）d,较对照组[（2.97±1.10）d]延长（P〈0.05）。结论头孢哌酮舒巴坦联合米诺环素治疗多重耐药鲍曼不动杆菌肺炎有很好的效果,值得在临床上广泛应用。

Objective To observe the curative effect of cefoperazone-sulbactam plus minocycline in the treatment of multidrug-resistance Acinetobacter baumannii. pneumonia. Methods Sixty-three patients with Acinetobacter baumannii. pneumonia were randomly divided into two groups： cefoperazone-sulbactam plus minocycline group（ treatment group,n = 33） and cefoperazone-sulbactam plus tigecyline group（ control group,n = 30）. The changes of WBC,CRP,PCT, temperature,clinical cure rates and microbiological eradication were observed. Results After treatment,WBC,CRP and PCT of treatment group were（ 7. 04 ± 1. 87） × 109,（ 4. 34 ± 2. 90） mg /L and（ 1. 04 ± 0. 50） mg /mL,which were significantly decreased（ P〈0. 05）. The clinical cure rate and clearance rate of bacteria in treatmer group were 69. 70% and 45. 5%, there was no significant difference compared with control group（ P〉0. 05）. The time of body temperature recovering to normal in treatment group [（ 3. 62 ± 1. 53） d]was significantly longer than that of control group [（ 2. 97 ± 1. 10） d]（ P〈0. 05）. Conclusion Cefoperazone-sulbactam combined with minocycline has good efficacy in the treatment of multidrug-resistant Acinetobacter baumannii. pneumonia, and it is worthy of clinical application.