奥马环素对社区获得性肺炎患者的疗效及安全性观察

Clinical evaluation of efficacy and safety of omadacycline in the treatment of patients with community acquired pneumonia

目的探讨以奥马环素为基础的治疗方案对社区获得性肺炎(CAP)患者的疗效及安全性。方法收集2023年1月至5月南昌大学第一附属医院以奥马环素或奥马环素联用β内酰胺类-β内酰胺酶抑制剂复方制剂为基础方案治疗的成年CAP患者临床资料。根据用药记录分为不联用组、联用组,观察临床疗效、微生物学疗效以及药物相关不良事件。结果在纳入的135例成人CAP患者中,合并慢性肝病23例(17.04%)、慢性肾病25例(18.52%)。不联用组64例(47.41%)。总体治疗临床有效率81.48%(110/135)。不联用组的整体临床有效率79.69%(51/64),其中普通病房患者有效率86.36%(38/44)。总体药物相关不良事件15例21例次,均为轻中度,主要引起恶心。结论奥马环素对于中国成人CAP的临床疗效较好,尤其是对普通病房CAP患者疗效显著,并且奥马环素安全性良好,不良反应多为轻中度,患者可耐受。

Objective To evaluate the efficacy and safety of the omadacycline-based therapies in patients with communityacquired pneumonia(CAP).Methods The clinical data of CAP patients treated with omadacycline(±β-lactam/β-lactamase inhibitor)in the First Affiliated Hospital of Nanchang University from January to May 2023 were reviewed and analyzed.The patients were assigned to omadacycline alone or omadacycline plusβ-lactam/β-lactamase inhibitor treatment group.The clinical efficacy,microbiological efficacy,and drug-related adverse events were summarized and compared between groups.Results A total of 135 adult patients with CAP were enrolled,including 23(17.04%)patients with chronic liver disease,25(18.52%)patients with chronic kidney disease,and 64(47.41%)patients treated with omadacycline alone.The overall clinical efficacy rate was 81.48%(110/135),specifically 79.69%(51/64)in the patients treated with omadacycline alone and 83.10%(59/71)in the patients treated with omadacycline plusβ-lactam/β-lactamase inhibitor.The clinical efficacy rate was 86.36%(38/44)in the patients treated in the general ward.Overall,21 cases of drug-related adverse events(mainly nausea)were reported in 15 patients,all of which were mild to moderate.Conclusions Omadacycline has shown good therapeutic effect in treatment of CAP in Chinese adults,especially for the patients treated in general ward.Most of the adverse events of omadacycline were mild to moderate and tolerable.