高剂量替加环素治疗ICU患者肺部感染的临床疗效

The Clinical Efficacy of High-dose Tigecycline in ICU Patients with Pulmonary Infections

目的探讨高剂量替加环素治疗ICU患者肺部感染的临床疗效和细菌学疗效。方法选取2018年3月~2020年10月于广东省人民医院ICU病房接受替加环素治疗的肺部感染患者82例,其中接受标准剂量替加环素治疗(负荷剂量100 mg,维持剂量50 mg q12h)的患者26例,接受高剂量替加环素治疗(100 mg q12h)的患者56例。结果高剂量组的临床有效率和细菌清除率62.5%(35/56)和50.8%(33/65),均高于标准剂量组38.5%(10/26)和26.7%(8/30),差异有统计学意义(P<0.05)。临床有效的独立预测因素是使用高剂量的替加环素(OR=3.341,95%CI:1.096~10.186,P=0.034)和替加环素的治疗时长(OR=1.249,95%CI:1.105~1.411,P=0.0004)。结论对ICU肺部感染患者,高剂量的替加环素以及恰当的治疗时长具有更好的临床疗效和微生物清除率。

OBJECTIVE To evaluate the clinical efficacy and bacterial eradication efficacy of high-dose tigecycline in ICU patients with pulmonary infections.METHODS From March 2018 to October 2020,82 patients who were receiving tigecycline treatment for pulmonary infections in the adult ICU of Guangdong Provincial People’s Hospital were enrolled in this study.Among them,26 patients had received the treatment of standard-dose tigecycline(loading dose 100 mg,maintenance dose 50 mg q12 h),while 56 patients had received therapy of high-dose tigecycline(100 mg q12 h).RESULTS The rates of clinical efficacy and bacterial eradication in the high-dose tigecycline group were 62.5%(35/56)and 38.5%(33/65),which were higher than clinical efficacy rate and bacterial eradication rate at 26.7%(8/30)and 26.7%(8/30)of the standard-dose tigecycline group after therapy,The difference was statistically significant(P<0.05).The independently protective factor of clinical effectiveness was the use of high-dose tigecycline(OR=3.341,95%CI:1.096-10.186,P=0.034)and the duration of tigecycline treatment(OR=1.249,95%CI:1.105-1.411,P=0.0004).CONCLUSION For critically ill adult patients with pulmonary infection,high-dose tigecycline and appropriate treatment duration make significant impact on clinical efficacy and microbial clearance.