利奈唑胺和万古霉素治疗化脓性脊柱炎的疗效、安全与经济性比较

Comparison between linezolid and vancomycin treatment of purulent spondylitis in effectiveness, safety and economy

目的 比较万古霉素与利奈唑胺治疗化脓性脊柱炎的有效性、安全性和经济性。方法 回顾性分析某三级医院2019年1月—2022年12月骨科收治的使用万古霉素或利奈唑胺治疗的化脓性脊柱炎患者120例病历资料。其中使用万古霉素者71例(万古霉素组),使用利奈唑胺者49例(利奈唑胺组),收集两组患者的炎性指标、不良反应、抗菌药物治疗时间及抗菌药物总费用的资料,比较两组患者治疗的有效性、安全性及经济性。结果 万古霉素组和利奈唑胺组两组患者治疗后白细胞计数(WBC)、C反应蛋白(CRP)、疼痛视觉模拟量表(VAS)评分、Oswestry功能障碍指数(ODI)均低于治疗前,差异均具有统计学意义(均P<0.05);两组患者治疗后的上述指标比较,差异无统计学意义(均P>0.05);抗菌药物治疗时间和不良反应发生率比较,差异均无统计学意义(均P>0.05);而利奈唑胺组患者抗菌药物总费用低于万古霉素组,差异有统计学意义(P<0.05)。结论 利奈唑胺治疗化脓性脊柱炎的有效性、安全性与万古霉素相当,经济性优于万古霉素。

Objective To compare the effectiveness,safety,and economy between vancomycin and linezolid in the treatment of suppurative spondylitis.Methods Medical records of 120 patients with suppurative spondylitis and treated with vancomycin or linezolid in the orthopedic department of a tertiary hospital from January 2019 to December 2022 were retrospectively analyzed.71 patients were treated with vancomycin(vancomycin group)and 49 with linezolid(linezolid group).Data about inflammatory indicators,adverse reactions as well as treatment time and total cost of antimicrobial agents were collected,the effectiveness,safety,and economy of two groups of patients were compared.Results The white blood cell count(WBC),C-reactive protein(CRP),pain visual analogue scale(VAS),and Oswestry disability index(ODI)of patients in vancomycin and linezolid groups after treatment were all lower than before,with statistically significant differences(all P<0.05).There were no statistically significant differences in the above indicators,treatment time and adverse reaction incidence of antimicrobial treatment between the two groups after treatment(all P>0.05).While the total cost of antimicrobial treatment in linezolid group was lower than that in vancomycin group,with a statistically significant difference(P<0.05).Conclusion The effectiveness and safety of linezolid in the treatment of suppurative spondylitis are comparable to vancomycin,but the economy is superior to vancomycin.