利奈唑胺和万古霉素治疗重症医学科MRSA肺部感染的疗效及安全性评价

Evaluation on efficacy and safety of linezolid and vancomycin in treatment of pulmonary infections caused by MRSA in ICU

目的分析评价利奈唑胺和万古霉素对重症医学科患者耐甲氧西林金黄色葡萄球菌(MRSA)肺部感染的治疗效果及安全性。方法选取重症医学科MRSA肺部感染患者85例,随机分为利奈唑胺组(43例)和万古霉素组(42)例,分别给予利奈唑胺(0.6g/次,2次/d)和万古霉素(1.0g/次,2次/d)治疗,疗程均为10-14d,比较两组的临床疗效、细菌清除率及不良反应发生率。结果利奈唑胺与万古霉素对MRSA肺部感染的治愈率分别为27.91%和26.19%,总有效率分别为72.09%和71.43%;细菌清除率分别为79.07%和64.29%;不良反应分别为6.98%和7.14%。两组患者的MRSA肺部感染治愈率、总有效率、肺部感染相关指标比较、无显著统计学差异(P>0.05),细菌清除率比较差异具有显著统计学差异(P<0.05)。结论利奈唑胺和万古霉素治疗ICU MRSA肺部感染均具有较高的敏感性,临床疗效和安全性相当,利奈唑胺的细菌清除率略高于万古霉素。

Objective To evaluate the efficacy and safety of linezolid and vancomycin in treatment of pulmo-nary infections caused by MRSA in ICU. Methods 85 patients with MRSA pulmonary infection in ICU were divided into the linezolid group （ n = 43 ） and the vancomycin group （ n = 42）. All of them received 0.6g linezolid or 1 g van- comycin every 12 h daily for 10-14 days. The therapeutic effect, bacterial clearance and adverse events of the 2 groups were compared after treatment. Results The rate of full recovery and total effective were 27. 91% and 72. 09% in the linezolid group versus 26. 19% and 71.43% in the vancomycin group. The rate of bacterium clear- ance was 79.07% in the linezolid group and 64. 29% in the vancomycin group, and the incidence of side effects were 8. 5% and 5. 4% respectively. There was no significant difference in full recovery, side effects and lung infection between the two groups （P 〉 0. 05 ）, but the rate of bacterium clearance was statistically different between the 2 groups （P 〈 0. 05 ）. Conclusion Linezolids and vancomycin have high sensitivity in treatment of pulmonary infec- tions caused by MRSA in ICU, their clinical efficacy and safety are similar, but the bacterium clearance rate of lin- ezolid is higher than vancomycin.