利奈唑胺与去甲万古霉素治疗耐甲氧西林金黄色葡萄球菌的疗效、安全性及经济性对比分析

Comparative analysis of the efficacy,safety and economy of linezolid and norvancomycin in the treatment of methicillin-resistant Staphylococcus aureus

目的探讨利奈唑胺与去甲万古霉素治疗耐甲氧西林金黄色葡萄球菌(MRSA)的疗效、安全性及经济性。方法回顾性分析2019年1月至2020年11月广西医科大学附属第七医院感染科收治的180例MRSA患者临床资料,根据采用的药物治疗方案不同分组,其中采用去甲万古霉素治疗的为对照组(n=90),采用利奈唑胺治疗的为研究组(n=90),观察两组治疗临床疗效、细菌学疗效及治疗前、治疗1个疗程后血清C反应蛋白(CRP)与白细胞计数(WBC);观察药物不良反应及药物经济性。结果研究组临床总有效率为90.00%,高于对照组的76.67%,差异有统计学意义(P<0.05);研究组细菌学疗效总清除率为87.78%,高于对照组的75.56%,差异有统计学意义(P<0.05);治疗1个疗程后两组CRP、WBC较治疗前下降(P<0.05);且研究组CRP、WBC低于对照组,差异有统计学意义(P<0.05);对照组与研究组不良反应发生率比较,差异无统计学意义(P>0.05);研究组临床疗效费用比、细菌疗效费用比低于对照组。结论与去甲万古霉素比较,利奈唑胺治疗MRSA的临床疗效、细菌学疗效更好,降低CRP、WBC效果更好,两种药物不良反应均较少,安全性高,但利奈唑胺的经济性更低。

Objective To investigate the efficacy,safety and economy of linezolid and norvancomycin in the treatment of methicillin-resistant Staphylococcus aureus(MRSA).Methods The clinical data of 180 patients with MRSA admitted to the Infectious Diseases Department of the Seventh Affiliated Hospital of Guangxi Medical University from January 2019 to November 2020 was retrospectively analyzed.According to different drug treatment programs,patients treated with norvancomycin were grouped into the control group(n=90),and patients treated with linezolid were grouped into the study group(n=90).The clinical efficacy,bacteriological efficacy,serum C-reactive protein(CRP)and white blood cell count(WBC)before treatment and after one course of treatment in the two groups were observed.The adverse drug reactions and drug economy were also observed.Results The total effective rate of clinical efficacy of the study group(90.00%)was higher than that of the control group(76.67%),and the difference was statistically significant(P<0.05).The total clearance of bacteriological efficacy of the study group(87.78%)was higher than that of the control group(75.56%),and the difference was statistically significant(P<0.05).After one course of treatment,the CRP and WBC of the two groups were lower than those of before treatment(P<0.05).The CRP and WBC of the study group were lower than those of the control group,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the control group and the study group(P>0.05).The cost ratio of clinical efficacy and the cost ratio of bacterial efficacy of the study group were lower than those of the control group.Conclusion Compared with norvancomycin,linezolid has better clinical efficacy and bacteriological efficacy in the treatment of MRSA,and has a better effect on reducing CRP and WBC.The two drugs have fewer adverse reactions and high sa fety,but linezolid is more economical.