奥马环素对比美罗培南联合利奈唑胺治疗肺部感染:一项真实世界队列研究

Comparison of omadacycline and meropenem plus linezolid in treatment of pulmonary infection:A real-world cohort study

目的评估奥马环素治疗肺部感染患者的疗效和安全性。方法回顾性分析2021年12月至2022年5月浙江大学医学院附属第一医院、杭州红十字会医院和建德市第一人民医院收治的58例肺部感染患者的临床资料,根据用药情况分为奥马环素治疗组(n=29)和美罗培南联合利奈唑胺治疗组(联合治疗组,n=29),奥马环素治疗组采用静脉注射奥马环素200 mg或100 mg,1次/d,联合治疗组静脉注射美罗培南(1000 mg/次,3次/d)和利奈唑胺(600 mg/次,2次/d);观察2组患者的临床疗效和药物相关不良反应。采用SPSS 22.0统计软件对数据进行处理。结果奥马环素组治愈、好转、恶化例数分别为8例(27.6%,8/29)、19例(65.5%,19/29)和2例(6.9%,2/29),联合治疗组治愈1例(3.4%,1/29),好转26例(89.7%,26/29),死亡2例(6.9%,2/29),奥马环素组的临床疗效优于联合治疗组(χ^(2)=6.533,P=0.038)。奥马环素组3例(10.3%,3/29)发生呼吸衰竭,联合治疗组5例(17.2%,5/29)发生呼吸衰竭,2组差异无统计学意义(χ^(2)=0.580,P=0.446)。在治愈或好转的患者中,奥马环素组从治疗开始到疾病缓解的中位时间为3.0(2.0,5.5)d;联合治疗组疾病缓解的中位时间为5.0(4.0,6.0)d。奥马环素组相较于联合治疗组,从治疗开始到疾病缓解的时间间隔更短(Z=-2.122,P=0.034)。两组不良反应发生率差异无统计学意义[6.9%(2/29)比13.8%(4/29),χ^(2)=0.744,P=0.389]。结论奥马环素治疗肺部感染患者疗效好,安全性佳,可优先用于治疗肺部感染。

Objective To compare the efficacy and safety of omacycline with meropenem plus linezolid in the treatment of patients with pulmonary infection.MethodsThe clinical data of 58 patients with pulmonary infection admitted to the First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou Red Cross Hospital and Jiande First People’s Hospital from December 2021 to May 2022 were retrospectively analyzed.The patients were divided into the omacycline group(n=29)and the meropenem combined with linezolid group(combined group,n=29).The omacycline group was given intravenous omacycline 200 mg or 100 mg,q.d,and the combined group was given intravenous meropenem(1000 mg,t.i.d)and linezolid(600 mg,b.i.d).The clinical efficacy and drug-related adverse events of two groups were observed.SPSS 22.0 statistical software was used for data analysis.ResultsIn the omacycline group,8 cases(27.6%,8/29)were cured,19 cases(65.5%,19/29)were improved,and 2 cases(6.9%,2/29)were worsened.In the combined group,1 case(3.4%,1/29)was cured,26 cases(89.7%,26/29)were improved,and 2 cases(6.9%,2/29)died.There was a statistically significant difference between the two groups(χ^(2)=6.533,P=0.038).The respiratory failure occurred in 3 cases(10.3%,3/29)of the omacycline group and 5 cases(17.2%,5/29)of the combined group(χ^(2)=0.580,P=0.446).In those patients who were cured or improved,the median time from treatment initiation to disease remission was 3.0(2.0,5.5)d in the omacycline group and 5.0(4.0,6.0)d in the combined group(Z=-2.122,P=0.034).There was no significant difference in the incidence of adverse reactions between the two groups[6.9%(2/29)vs.13.8%(4/29),χ^(2)=0.744,P=0.389].ConclusionOmacycline exhibits a good efficacy and safety in the treatment of patients with pulmonary infection,which may be prioritized for the treatment of pulmonary infections.