延长抗生素输注时间或增加剂量对RICU铜绿假单胞菌感染患者疗效和安全性的影响

Effect of Prolonged Antibiotic Infusion Time or Increased Dose on Efficacy and Safety of Patients Infected with Pseudomonas Aeruginosa RICU

目的:探讨延长抗生素输注时间或增加剂量对呼吸重症监护病房(RICU)铜绿假单胞菌(PA)感染患者疗效和安全性的影响。方法:选取2021年5月—2023年8月麻城市人民医院RICU住院治疗的150例PA感染患者作为研究对象。采用随机数表法将其分为A、B、C组,每组各50例。A组给予大剂量30 min输注治疗,B组给予大剂量3 h输注治疗,C组给予小剂量3 h输注治疗。比较3组治疗后体温和白细胞计数变化、治疗总有效率、细菌清除率和治疗期间不良反应发生率情况。结果:治疗后,3组体温、白细胞计数均降低,差异有统计学意义(P<0.05);治疗后,B组体温、白细胞计数均低于A组、C组,差异有统计学意义(P<0.05);治疗后,A、C组两组体温、白细胞计数比较,差异无统计学意义(P>0.05)。3组治疗总有效率比较,差异有统计学意义(P<0.05);其中B组治疗总有效率高于A,C组,差异有统计学意义(P<0.05);A、C两组比较,差异无统计学意义(P>0.05)。3组停药当天细菌清除率比较,差异有统计学意义(P<0.05);B组患者细菌清除率均高于A组、C组,差异有统计学意义(P<0.05);A、C组两组细菌清除率比较,差异无统计学意义(P>0.05)。3组治疗期间不良反应率分别为5.3%、5.3%和4.0%,差异无统计学意义(P>0.05)。3组患者住院时间比较,差异有统计学意义(P<0.05);B组的RICU住院时间均低于A组、C组,差异有统计学意义(P<0.05);A、C两组比较,差异无统计学意义(P>0.05)。结论:适当延长美罗培南输注时间和增加剂量能够提高RICU中PA感染患者的治疗效果,安全性较好。

Objective:To investigate the effect of prolonged antibiotic infusion time or increased dose on the efficacy and safety of patients with pseudomonas aeruginosa(PA)infection in respiratory intensive care unit(RICU).Method:150 patients were divided into groups A,B and C by random number table method,with 50 cases in each group.Group A received high-dose 30 min infusion therapy,group B received high-dose 3 h infusion therapy,and group C received low-dose 3 h infusion therapy.The changes of body temperature and white blood cell count,total effective rate,bacterial clearance rate and the incidence of adverse reactions during treatment were compared among the 3 groups.Result:After treatment,the body temperature and white blood cell count of 3 groups were decreased,the difference was statistically significant(P<0.05).After treatment,the body temperature and white blood cell count of group B were lower than those of group A and group C,the difference was statistically significant(P<0.05).After treatment,there was no significant difference in body temperature and white blood cell count between groups A and C(P>0.05).The total effective rate of the three groups was statistically significant(P<0.05).The total effective rate of group B was higher than that of group C,the difference was statistically significant(P<0.05).The total effective rate of group B was higher than that of group A,with no statistical significance(P>0.05).There was no significant difference between group A and group C(P>0.05).There was statistical significance in the bacterial clearance rate of 3 groups on the day of drug withdrawal(P<0.05).The bacterial clearance rate of group B was higher than that of group A and group C,the difference was statistically significant(P<0.05).There was no significant difference in bacterial clearance between groups A and C(P>0.05).The adverse reaction rates of the three groups were 5.3%,5.3%and 4.0%,respectively,with no statistical significance(P>0.05).There was statistical significance in the length of hospital stay among the three groups(P<0.05).The hospitalization time of RICU in group B was lower than that in group A and group C,and the difference was statistically significant(P<0.05).There was no significant difference between group A and group C(P>0.05).Conclusion:Appropriately prolonging the infusion time and increasing the dosage of meropenem can improve the therapeutic effect of patients with Pseudomonas aeruginosa infection in RICU with good.