达托霉素治疗革兰阳性菌脓毒症的临床疗效

Clinical efficacy of daptomycin in the treatment of Gram-positive bacterial sepsis

目的评价达托霉素治疗革兰阳性菌脓毒症的临床疗效和安全性。方法回顾性分析2016年1月~2019年6月天津市人民医院符合革兰阳性菌脓毒症诊断标准并接受达托霉素与万古霉素治疗的住院患者,记录并分析其一般临床资料、疗效性指标、安全性指标等。结果 29例革兰阳性菌脓毒症患者在达托霉素治疗结束时总有效率为79.31%,细菌转阴率为75.86%,体温降至正常的平均时间为(4.95±3.22)d,其中有3例患者发生不良反应,但均未出现严重后果,与万古霉素治疗组(25例)比较,达托霉素组有效率、细菌转阴率、不良反应发生率未见明显差异,但体温下降时间、4d培养阳性率明显低于万古霉素组(P <0.05)。结论达托霉素对革兰阳性菌脓毒症临床疗效可,起效迅速,无明显药物不良反应,值得临床推荐。

Objective To evaluate the clinical efficacy and safety of daptomycin in the treatment of Gram-positive bacterial sepsis. Methods The patients hospitalized in the People’s Hospital of Tianjin from January 2016 to June 2019 who met the diagnostic criteria of Gram-positive bacterial sepsis and received the treatment of daptomycin and vancomycin were retrospectively analyzed, and their general clinical data, efficacy indexes and safety indexes were recorded and analyzed. Results Among 29 patients with Gram-positive bacterial sepsis at the end of daptomycin treatment, the total effective rate was 79.31%, the bacterial negative conversion rate was 75.86%, and the average time for the body temperature to drop to normal was(4.95±3.22) d. Among them, 3 patients had adverse reactions(ADRs), but no serious consequences occurred. Compared with those of the vancomycin treatment group(n=25), the effective rate, the bacterial negative conversion rate and the incidence of ADRs of the daptomycin group showed no significant differences, but the time for the body temperature to drop and the positive rate of bacterial culture in 4 days were obviously lower than those in the vancomycin treatment group(P < 0.05). Conclusion The clinical efficacy of daptomycin in the treatment of Gram-positive bacterial sepsis is remarkable, and it takes effect quickly without obvious ADRs, so it is worthy of recommendation in clinical practice.