替考拉宁和万古霉素治疗革兰阳性菌感染疗效及安全性比较

Efficacy and safety of teicoplanin and vancomycin in the treatment of gram-positive bacterial infections

目的:探讨替考拉宁与万古霉素治疗革兰阳性菌感染的临床疗效与安全性。方法:收集解放军总医院2012年1月–2016年4月期间住院病历数据库记载ICU和RICU分别应用替考拉宁和万古霉素两种药物治疗的临床病历,通过收集其人口学资料、基础疾病、伴随用药、用药疗程以及疗效、细菌清除和不良反应情况,通过SPSS 17.0分析比较两组药物的临床疗效及安全性。结果:在临床治疗有效率、细菌清除率方面,替考拉宁组的有效率和细菌清除率分别为32.3%和29.6%,与万古霉素组的有效率(38.7%)和细菌清除率(44.0%)相比差异无统计学意义,但替考拉宁具有低不良反应发生率的优势,差异具有统计学意义(P<0.05)。两组患者的中青年患者与老年患者在临床疗效、细菌清除率和不良反应发生率方面差异无统计学意义,但不良反应发生率均为老年人大于中青年人。结论:替考拉宁治疗革兰阳性菌感染的疗效与万古霉素相当,但替考拉宁在相同条件下比万古霉素安全性更高。

Objective:To evaluate the clinical efficacy and safety of teicoplanin and vancomycin in the treatment of grampositivebacterial infections.Methods:By exploring the medical records databases of Chinese PLA General Hospital,the data wascollected including the demographic data,underlying diseases,concomitant medication,course of treatment,treatment efficacy,bacterial clearance and adverse reactions of the patients who received teicoplanin or vancomycin in ICU and RICU wards fromJanuary2012to April2016,the efficacy and safety were compared by SPSS17.0.Results:The efficacy rate and bacterial clearancerate in teicoplanin group were32.3%and29.6%,respectively.There was no statistical significance when compared with vancomycingroup(clinical efficacy rate and bacterial clearance rate were38.7%and44.0%respectively).While,teicoplanin had an advantage oflow incidence of adverse reactions with statistical significance(P<0.05).There was no statistical significance on the clinical efficacyand bacterial clearance rate between elderly patients and younger patients in both groups,while the incidence of adverse reactionswas higher in elderly patients.Conclusion:The efficacy of treating gram-positive bacterial infections by teicoplanin was equivalentwith vancomycin,while under the same conditions teicoplanin was safer than vancomycin.